Provider Demographics
NPI:1275643363
Name:BOSKY, JOAN M (LMFT)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:BOSKY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 FESLER ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-1968
Mailing Address - Country:US
Mailing Address - Phone:619-440-4211
Mailing Address - Fax:619-440-4205
Practice Address - Street 1:500 FESLER ST
Practice Address - Street 2:SUITE 208
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-1968
Practice Address - Country:US
Practice Address - Phone:619-440-4211
Practice Address - Fax:619-440-4205
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35623106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist