Provider Demographics
NPI:1699897660
Name:RELYEA, MISTY JOY (LCSW)
Entity type:Individual
Prefix:MS
First Name:MISTY
Middle Name:JOY
Last Name:RELYEA
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 1:24533 NOVATO PL
Mailing Address - Street 2:
Mailing Address - City:RAMONA
Mailing Address - State:CA
Mailing Address - Zip Code:92065-4168
Mailing Address - Country:US
Mailing Address - Phone:760-789-6324
Mailing Address - Fax:
Practice Address - Street 1:9400 RUFFIN CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-5300
Practice Address - Country:US
Practice Address - Phone:858-514-4872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS197591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical