Clark, Joy Jean

Clark, Joy Jean is an sole proprietor health care provider with primary practice located at 120 E. Kimball Avenue Suite 2, Hemet CA 92543. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Clark, Joy Jean can be contacted via phone (951) 392-3219.

Contact Information

Primary practice address
120 E. Kimball Avenue Suite 2 Hemet CA 92543
Phone: (951) 392-3219
Fax: (951) 392-3087
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY11556 California
Behavioral Health & Social Service Providers / Forensic 103TF0200X PSY11556 California

Profile Details

NPI number 1538253174
LBN Legal business name Clark, Joy Jean
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 3rd, 2006
Last updated Nov 29th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538253174 NPPES
Other 0PL115560 MEDICARE ID
Other PSY11556 MEDICARE ID
MEDICAID PSY115560 MEDICARE ID

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