MEDICARE: JACLYN JOYCE D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	A15156	CA

General Provider Information

NPI Number	:	1114312147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACLYN JOYCE D.O.

Provider Business Mailing Address
First Line	:	2907 SHELTER ISLAND DR STE 105-359
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92106-2743
Country	:	US
Telephone Number	:	619-343-2039
Fax Number	:

Provider Business Practice Location Address
First Line	:	2907 SHELTER ISLAND DR STE 105-359
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92106-2743
Country	:	US
Telephone Number	:	619-343-2039
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2015
Last Update Date	:	07/16/2021

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