Provider Demographics
NPI:1811469562
Name:JOYA-POLANIA, JELEANY
Entity type:Individual
Prefix:
First Name:JELEANY
Middle Name:
Last Name:JOYA-POLANIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 SEPULVEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-2649
Mailing Address - Country:US
Mailing Address - Phone:818-895-9707
Mailing Address - Fax:
Practice Address - Street 1:10200 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-2649
Practice Address - Country:US
Practice Address - Phone:818-895-9707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator