Provider Demographics
NPI:1952567356
Name:JOY, BRIAN RAYMOND (MA, LMFT # 113211)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:RAYMOND
Last Name:JOY
Suffix:
Gender:M
Credentials:MA, LMFT # 113211
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11512 B AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-2605
Mailing Address - Country:US
Mailing Address - Phone:916-543-7437
Mailing Address - Fax:
Practice Address - Street 1:10810 JUSTICE CENTER DR STE 170
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-6231
Practice Address - Country:US
Practice Address - Phone:916-543-7437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65857106H00000X
CA113211106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist