Healthcare Provider Details

I. General information

NPI: 1912464280
Provider Name (Legal Business Name): JOYCELIN DIANNE UMANZOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2019
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2151 SALVIO ST STE 301
CONCORD CA
94520-6304
US

IV. Provider business mailing address

2151 SALVIO ST STE 301
CONCORD CA
94520-6304
US

V. Phone/Fax

Practice location:
  • Phone: 925-726-6217
  • Fax:
Mailing address:
  • Phone: 925-671-0777
  • Fax: 925-681-1614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number135780
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: