Provider Demographics
NPI:1326529702
Name:PULLUM, JOYCE MARIE
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:MARIE
Last Name:PULLUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22280 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-4005
Mailing Address - Country:US
Mailing Address - Phone:209-475-2209
Mailing Address - Fax:
Practice Address - Street 1:682 BRIERGATE WAY
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-7245
Practice Address - Country:US
Practice Address - Phone:510-773-1932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)