Provider Demographics
NPI:1114475993
Name:PENALOZA, JOYLYNN COMIA (PSYD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:JOYLYNN
Middle Name:COMIA
Last Name:PENALOZA
Suffix:
Gender:F
Credentials:PSYD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 SE 149TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-8516
Mailing Address - Country:US
Mailing Address - Phone:360-600-5812
Mailing Address - Fax:
Practice Address - Street 1:2211 SE 149TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-8516
Practice Address - Country:US
Practice Address - Phone:360-600-5812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60152239101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health