Healthcare Provider Details

I. General information

NPI: 1134675309
Provider Name (Legal Business Name): JOSHUA DANIEL PRICE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 08/19/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44443 10TH ST W
LANCASTER CA
93534-3346
US

IV. Provider business mailing address

27923 OAKGALE AVE
SANTA CLARITA CA
91351-1036
US

V. Phone/Fax

Practice location:
  • Phone: 661-726-2630
  • Fax:
Mailing address:
  • Phone: 661-313-4534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number120941
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: