Provider Demographics
NPI:1508162686
Name:KOLKER, JOY STEPHENSON (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOY
Middle Name:STEPHENSON
Last Name:KOLKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:J S
Other - Last Name:KOLKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 4071
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-0407
Mailing Address - Country:US
Mailing Address - Phone:707-257-7900
Mailing Address - Fax:
Practice Address - Street 1:818 CHERRY ST
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4207
Practice Address - Country:US
Practice Address - Phone:707-257-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-07
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23656103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical