Basic Information
Provider Information
NPI: 1730424326
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ENGEL
FirstName: JOY
MiddleName: M
NamePrefix: MRS.
NameSuffix:  
Credential: R.N.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MUHLENFELD
OtherFirstName: JOY
OtherMiddleName: M
OtherNamePrefix: MS.
OtherNameSuffix:  
OtherCredential: R.N.
OtherLastNameType: 1
Mailing Information
Address1: 720 WOOD ST
Address2:  
City: EUREKA
State: CA
PostalCode: 95501
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 720 WOOD ST
Address2:  
City: EUREKA
State: CA
PostalCode: 955014413
CountryCode: US
TelephoneNumber: 7072682900
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/07/2012
LastUpdateDate: 05/27/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WP0808X821325CAY Nursing Service ProvidersRegistered NursePsych/Mental Health

No ID Information.


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