Provider Demographics
NPI:1417038829
Name:CACI, JOYCE ANN
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:ANN
Last Name:CACI
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:PO BOX 131292
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92013-1292
Mailing Address - Country:US
Mailing Address - Phone:760-815-1408
Mailing Address - Fax:
Practice Address - Street 1:3434 GROVE STREET
Practice Address - Street 2:
Practice Address - City:LEMON GROVE
Practice Address - State:CA
Practice Address - Zip Code:91945
Practice Address - Country:US
Practice Address - Phone:619-787-6320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40792106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist