Provider Demographics
NPI:1689054231
Name:JOY, KALEEM (LM)
Entity Type:Individual
Prefix:
First Name:KALEEM
Middle Name:
Last Name:JOY
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7862 GLEN ECHO ST
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-2406
Mailing Address - Country:US
Mailing Address - Phone:916-412-6443
Mailing Address - Fax:916-727-6443
Practice Address - Street 1:7862 GLEN ECHO ST
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-2406
Practice Address - Country:US
Practice Address - Phone:916-412-6443
Practice Address - Fax:916-727-6443
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM 63176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife