Provider Demographics
NPI:1912043910
Name:MALIK-HASBROOK, JOY RADHA (PSYD)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:RADHA
Last Name:MALIK-HASBROOK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 E COLORADO BLVD STE 214
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3840
Mailing Address - Country:US
Mailing Address - Phone:747-224-7303
Mailing Address - Fax:
Practice Address - Street 1:3030 E COLORADO BLVD STE 214
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107
Practice Address - Country:US
Practice Address - Phone:747-224-7303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 22923103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical