Provider Demographics
NPI:1174341499
Name:SUSAN JOYNER
Entity type:Organization
Organization Name:SUSAN JOYNER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOYNER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCSW-C
Authorized Official - Phone:650-539-8507
Mailing Address - Street 1:PO BOX 438
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-0438
Mailing Address - Country:US
Mailing Address - Phone:650-539-8507
Mailing Address - Fax:
Practice Address - Street 1:138 S B ST APT 2
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-3936
Practice Address - Country:US
Practice Address - Phone:650-539-8507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)