Provider Demographics
NPI:1265525547
Name:JOYCECHILD, MARIAN (PHD)
Entity type:Individual
Prefix:DR
First Name:MARIAN
Middle Name:
Last Name:JOYCECHILD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1947 DIVISADERO ST
Mailing Address - Street 2:5
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2532
Mailing Address - Country:US
Mailing Address - Phone:415-346-9466
Mailing Address - Fax:510-527-6311
Practice Address - Street 1:1947 DIVISADERO ST
Practice Address - Street 2:5
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2532
Practice Address - Country:US
Practice Address - Phone:415-346-9466
Practice Address - Fax:510-527-6311
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 12656103TC0700X
CAMFT15931106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPL126560Medicare ID - Type Unspecified