Provider Demographics
NPI:1477735660
Name:JOSEPH, DEWANDA JEAN (RAS)
Entity Type:Individual
Prefix:
First Name:DEWANDA
Middle Name:JEAN
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:RAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 WILLOW PASS RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94519-2588
Mailing Address - Country:US
Mailing Address - Phone:925-363-5000
Mailing Address - Fax:925-363-5075
Practice Address - Street 1:2280 DIAMOND BLVD STE 500
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5719
Practice Address - Country:US
Practice Address - Phone:925-483-2223
Practice Address - Fax:925-826-5878
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health