Healthcare Provider Details

I. General information

NPI: 1508765090
Provider Name (Legal Business Name): DAVID O JOSLYN PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2026
Last Update Date: 11/02/2026
Certification Date: 11/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3048 E BASELINE RD STE 118
MESA AZ
85204-7288
US

IV. Provider business mailing address

6031 E HALIFAX ST
MESA AZ
85205-4508
US

V. Phone/Fax

Practice location:
  • Phone: 623-260-1320
  • Fax:
Mailing address:
  • Phone: 941-773-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY-005158
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: