Provider Demographics
NPI:1093147175
Name:STEPHENS, JOYCELYN DIANE
Entity Type:Individual
Prefix:MS
First Name:JOYCELYN
Middle Name:DIANE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6305 SAN PABLO DR
Mailing Address - Street 2:APT 107
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-5742
Mailing Address - Country:US
Mailing Address - Phone:916-912-7039
Mailing Address - Fax:
Practice Address - Street 1:9916 ZION WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-2943
Practice Address - Country:US
Practice Address - Phone:916-287-4860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health