Healthcare Provider Details

I. General information

NPI: 1528910577
Provider Name (Legal Business Name): MRS. JOYCE JEANINE MCCOLLUM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16593 CHINA BERRY CT
CHINO HILLS CA
91709-6390
US

IV. Provider business mailing address

16593 CHINA BERRY CT
CHINO HILLS CA
91709-6390
US

V. Phone/Fax

Practice location:
  • Phone: 840-228-7740
  • Fax:
Mailing address:
  • Phone: 840-228-7740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: