Provider Demographics
NPI:1962999185
Name:KAY, JOAN EDWARDS (MA, LMFT)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:EDWARDS
Last Name:KAY
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4616 SANDYFORD CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-7839
Mailing Address - Country:US
Mailing Address - Phone:925-200-2813
Mailing Address - Fax:
Practice Address - Street 1:4625 1ST ST STE 235
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-7168
Practice Address - Country:US
Practice Address - Phone:192-526-2115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-13
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51274106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty