Provider Demographics
NPI:1821144924
Name:ERWIN, JOAN E (PHD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:E
Last Name:ERWIN
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 1:21297 FOOTHILL BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-1554
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21297 FOOTHILL BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-1554
Practice Address - Country:US
Practice Address - Phone:510-889-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 7462103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical