Provider Demographics
NPI:1497434591
Name:ACOSTA, JOY KATHLEEN
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:KATHLEEN
Last Name:ACOSTA
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 1:4401 MARRACO DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-5644
Mailing Address - Country:US
Mailing Address - Phone:619-636-5758
Mailing Address - Fax:
Practice Address - Street 1:4401 MARRACO DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-5644
Practice Address - Country:US
Practice Address - Phone:619-636-5758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula