Provider Demographics
NPI:1922443548
Name:BOYD, DANNY KAY JR (PT)
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:KAY
Last Name:BOYD
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 W LA CADENA DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-1413
Mailing Address - Country:US
Mailing Address - Phone:951-784-8010
Mailing Address - Fax:951-784-2859
Practice Address - Street 1:1021 W LA CADENA DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-1413
Practice Address - Country:US
Practice Address - Phone:951-784-8010
Practice Address - Fax:951-784-2859
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-09
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT35498167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician