Provider Demographics
NPI:1851407050
Name:MEDLEY, JOYCE L
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:L
Last Name:MEDLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JOYCE
Other - Middle Name:L
Other - Last Name:CHRISTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:9003 RESEDA BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-3920
Mailing Address - Country:US
Mailing Address - Phone:818-878-1492
Mailing Address - Fax:818-772-2545
Practice Address - Street 1:9003 RESEDA BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-3920
Practice Address - Country:US
Practice Address - Phone:818-878-1492
Practice Address - Fax:818-772-2545
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC27366106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist