Provider Demographics
NPI:1225819238
Name:DE JOYA, JOSHUA MIGUEL VERGEL DE DIOS (RD)
Entity Type:Individual
Prefix:
First Name:JOSHUA MIGUEL
Middle Name:VERGEL DE DIOS
Last Name:DE JOYA
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5254 OLIVA AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-2357
Mailing Address - Country:US
Mailing Address - Phone:562-310-8901
Mailing Address - Fax:
Practice Address - Street 1:15625 LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-4633
Practice Address - Country:US
Practice Address - Phone:562-790-2478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered