Provider Demographics
NPI:1356570360
Name:PASTOR, JONI FAY (PHD)
Entity type:Individual
Prefix:DR
First Name:JONI
Middle Name:FAY
Last Name:PASTOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JOAN
Other - Middle Name:FAYE
Other - Last Name:PASTOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:5054 AVENIDA DE LA PLATA
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-8000
Mailing Address - Country:US
Mailing Address - Phone:760-945-9767
Mailing Address - Fax:503-907-9767
Practice Address - Street 1:9171 WILSHIRE BLVD
Practice Address - Street 2:PENTHOUSE SUITE 1
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5530
Practice Address - Country:US
Practice Address - Phone:310-892-0210
Practice Address - Fax:503-390-7976
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-11
Last Update Date:2009-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 21808103G00000X, 103T00000X, 103TA0700X, 103TB0200X, 103TC1900X, 103TE1100X, 103TF0000X, 103TF0200X, 103TH0004X, 103TM1800X, 103TP2701X
CAPSY 21808103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy