Provider Demographics
NPI:1174108302
Name:KARUGA, JOYCE JANE N
Entity type:Individual
Prefix:MRS
First Name:JOYCE JANE
Middle Name:N
Last Name:KARUGA
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 1:215 W SWEET SHRUB AVE
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-6646
Mailing Address - Country:US
Mailing Address - Phone:573-529-6198
Mailing Address - Fax:
Practice Address - Street 1:215 W SWEET SHRUB AVE
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85140-6646
Practice Address - Country:US
Practice Address - Phone:573-529-6198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH6408320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD11041304OtherDMV