Provider Demographics
NPI:1609944511
Name:KEWLEY, JOYCE LYNNE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:LYNNE
Last Name:KEWLEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MRS
Other - First Name:JOYCE
Other - Middle Name:LYNNE
Other - Last Name:LUCAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:1974 MERLE DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001
Mailing Address - Country:US
Mailing Address - Phone:530-244-2149
Mailing Address - Fax:
Practice Address - Street 1:2940 COURT ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001
Practice Address - Country:US
Practice Address - Phone:530-246-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6358225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant