Provider Demographics
NPI:1881827723
Name:LA BIANCO, JOYCE VIRGINIA (LMFT)
Entity Type:Individual
Prefix:MISS
First Name:JOYCE
Middle Name:VIRGINIA
Last Name:LA BIANCO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 W 229TH ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-5335
Mailing Address - Country:US
Mailing Address - Phone:714-844-3787
Mailing Address - Fax:951-398-7235
Practice Address - Street 1:7177 BROCKTON AVE
Practice Address - Street 2:SUITE 452
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2631
Practice Address - Country:US
Practice Address - Phone:714-844-3787
Practice Address - Fax:951-398-7235
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-26
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 43494106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1881827723OtherMOLINA
CA1881827723Medicaid