Provider Demographics
NPI:1760264782
Name:PRISCILLA JOUVIN PSYCHOTHERAPY
Entity Type:Organization
Organization Name:PRISCILLA JOUVIN PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND LMFT
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOUVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMFT
Authorized Official - Phone:909-532-4191
Mailing Address - Street 1:11760 CARMEL CREEK RD # F305
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-6754
Mailing Address - Country:US
Mailing Address - Phone:909-523-4191
Mailing Address - Fax:
Practice Address - Street 1:11760 CARMEL CREEK RD # F305
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-6754
Practice Address - Country:US
Practice Address - Phone:909-523-4191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty