Provider Demographics
NPI:1366234304
Name:PRINCE, JOY M
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:M
Last Name:PRINCE
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 1:27857 BLOOMFIELD CT
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91354-1485
Mailing Address - Country:US
Mailing Address - Phone:661-219-1323
Mailing Address - Fax:
Practice Address - Street 1:25115 AVENUE STANFORD # A103
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1290
Practice Address - Country:US
Practice Address - Phone:661-219-1323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-17
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INTERN106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist