Basic Information
Provider Information
NPI: 1851726897
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JOYNER
FirstName: KRISTEN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PSY.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4650 W SUNSET BLVD
Address2: MS#53
City: LOS ANGELES
State: CA
PostalCode: 900276062
CountryCode: US
TelephoneNumber: 3233613849
FaxNumber:  
Practice Location
Address1: 4650 W SUNSET BLVD
Address2: MS #53
City: LOS ANGELES
State: CA
PostalCode: 900276062
CountryCode: US
TelephoneNumber: 3233613849
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/10/2013
LastUpdateDate: 07/01/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC2200XPSY27764CAY Behavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent

No ID Information.


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