Provider Demographics
NPI:1568689834
Name:NELSON-PATENAUDE, JOYCE ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:ANN
Last Name:NELSON-PATENAUDE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 2ND ST APT 6
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-1063
Mailing Address - Country:US
Mailing Address - Phone:310-393-1502
Mailing Address - Fax:310-393-1502
Practice Address - Street 1:1510 11TH ST STE 202
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-2939
Practice Address - Country:US
Practice Address - Phone:310-451-4619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAM12873106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist