Provider Demographics
NPI:1790430205
Name:MATSON, JOEL YOUNGSHIN (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:YOUNGSHIN
Last Name:MATSON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41856 IVY ST STE 205
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-8805
Mailing Address - Country:US
Mailing Address - Phone:951-396-5701
Mailing Address - Fax:
Practice Address - Street 1:41856 IVY ST STE 205
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-8805
Practice Address - Country:US
Practice Address - Phone:951-396-5701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-14
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94028474103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist