Provider Demographics
NPI:1720150808
Name:OGDEN, JOY LEE (CADC II)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:LEE
Last Name:OGDEN
Suffix:
Gender:F
Credentials:CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 E TABOR AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-3973
Mailing Address - Country:US
Mailing Address - Phone:707-435-8042
Mailing Address - Fax:707-435-1527
Practice Address - Street 1:1143 MISSOURI ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-6007
Practice Address - Country:US
Practice Address - Phone:707-435-8042
Practice Address - Fax:707-435-1527
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)