Provider Demographics
NPI:1518187236
Name:JOY, JOCELYN (LAC)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:JOY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 59TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92114-2319
Mailing Address - Country:US
Mailing Address - Phone:619-322-4492
Mailing Address - Fax:619-233-0046
Practice Address - Street 1:5252 BALBOA AVE
Practice Address - Street 2:SUITE 901
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-6906
Practice Address - Country:US
Practice Address - Phone:858-560-5022
Practice Address - Fax:858-560-8092
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 8306171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1063474OtherASHP DOC ID