Provider Demographics
NPI:1356767685
Name:JOYCE WECKL PMHNP A NURSING CORPORATION
Entity type:Organization
Organization Name:JOYCE WECKL PMHNP A NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:WECKL
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:805-654-0926
Mailing Address - Street 1:3585 MAPLE ST
Mailing Address - Street 2:SUITE # 205
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3504
Mailing Address - Country:US
Mailing Address - Phone:805-654-0926
Mailing Address - Fax:
Practice Address - Street 1:3585 MAPLE ST
Practice Address - Street 2:SUITE # 205
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3504
Practice Address - Country:US
Practice Address - Phone:805-654-0926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-11
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP6980363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP6980OtherPSYCHIATRIC NURSE PRACTITIONER LICENSE