Provider Demographics
NPI:1093838583
Name:EDWARDS-BECKETT, JOY (PHD, DNSC, FNPC, CW)
Entity Type:Individual
Prefix:DR
First Name:JOY
Middle Name:
Last Name:EDWARDS-BECKETT
Suffix:
Gender:F
Credentials:PHD, DNSC, FNPC, CW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 MARICOPA HWY
Mailing Address - Street 2:# 209
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-3167
Mailing Address - Country:US
Mailing Address - Phone:805-907-0876
Mailing Address - Fax:805-640-0868
Practice Address - Street 1:2220 LYNN RD
Practice Address - Street 2:SUITE 102
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-1904
Practice Address - Country:US
Practice Address - Phone:805-494-1222
Practice Address - Fax:805-494-1255
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA563873163W00000X
CA16925363LF0000X
CA2005454535163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA16925OtherNP LICENSE
CA563873OtherRN LICENSE