Provider Demographics
NPI:1184231730
Name:KAYE, JOANNA LESLEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:LESLEY
Last Name:KAYE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 FRAZEE RD STE 500
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4350
Mailing Address - Country:US
Mailing Address - Phone:619-330-4010
Mailing Address - Fax:
Practice Address - Street 1:1455 FRAZEE RD STE 500
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4350
Practice Address - Country:US
Practice Address - Phone:619-330-4010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32010103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical