Provider Demographics
NPI:1528795630
Name:ROY, JAYA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JAYA
Middle Name:
Last Name:ROY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1470 ENCINITAS BLVD # 22
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2930
Mailing Address - Country:US
Mailing Address - Phone:858-205-4399
Mailing Address - Fax:
Practice Address - Street 1:343 TRAILVIEW RD
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3126
Practice Address - Country:US
Practice Address - Phone:858-205-4399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1087671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical