Provider Demographics
NPI:1386653491
Name:JOEHNK, MARGORY ALICE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARGORY
Middle Name:ALICE
Last Name:JOEHNK
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 1:3400 WITHERSED LN
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3928
Mailing Address - Country:US
Mailing Address - Phone:925-451-2054
Mailing Address - Fax:925-465-5599
Practice Address - Street 1:3050 CITRUS CIR
Practice Address - Street 2:SUITE 114
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2698
Practice Address - Country:US
Practice Address - Phone:925-451-2054
Practice Address - Fax:925-465-5599
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 15559103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical