Provider Demographics
NPI:1912464280
Name:UMANZOR, JOYCELIN DIANNE
Entity type:Individual
Prefix:
First Name:JOYCELIN
Middle Name:DIANNE
Last Name:UMANZOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 SALVIO ST STE 301
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-6304
Mailing Address - Country:US
Mailing Address - Phone:925-671-0777
Mailing Address - Fax:925-681-1614
Practice Address - Street 1:2151 SALVIO ST STE 301
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-6304
Practice Address - Country:US
Practice Address - Phone:925-726-6217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-22
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA135780106H00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health