Provider Demographics
NPI:1770349490
Name:JOSEPH, JAY ARTHUR
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:ARTHUR
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 CABERNET CT APT 7E
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-2959
Mailing Address - Country:US
Mailing Address - Phone:530-366-8820
Mailing Address - Fax:
Practice Address - Street 1:15 CABERNET CT APT 7E
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-2959
Practice Address - Country:US
Practice Address - Phone:530-366-8820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician