Provider Demographics
NPI:1891785721
Name:SUNKIN, JOEL ROBERT (PHD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:ROBERT
Last Name:SUNKIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-3948
Mailing Address - Country:US
Mailing Address - Phone:562-861-0086
Mailing Address - Fax:
Practice Address - Street 1:8301 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3936
Practice Address - Country:US
Practice Address - Phone:562-861-0086
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY7314103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY7314Medicaid
CAPSY7314Medicaid
CAR30736Medicare UPIN