Provider Demographics
NPI:1902680556
Name:JOSEPH, JEBY (APRN ,PMHNP -BC)
Entity type:Individual
Prefix:MR
First Name:JEBY
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:APRN ,PMHNP -BC
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Mailing Address - Street 1:1902 WRIGHT PLACE , CORNERSTONE CORPORATE CENTER
Mailing Address - Street 2:2 ND FLOOR
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008
Mailing Address - Country:US
Mailing Address - Phone:301-385-6372
Mailing Address - Fax:
Practice Address - Street 1:1902 WRIGHT PLACE , CORNERSTONE CORPORATE CENTER
Practice Address - Street 2:2 ND FLOOR
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008
Practice Address - Country:US
Practice Address - Phone:301-385-6372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2024-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX1007837363LP0808X
CA95030576363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health