Healthcare Provider Details

I. General information

NPI: 1740809631
Provider Name (Legal Business Name): JOYCE HAKOUPIAN M.A. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOYCE HAKOUPIAN M.A. CCC-SLP

II. Dates (important events)

Enumeration Date: 04/10/2020
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2640 CENTER RD
NOVATO CA
94947-1942
US

IV. Provider business mailing address

2640 CENTER RD
NOVATO CA
94947-1942
US

V. Phone/Fax

Practice location:
  • Phone: 650-278-3696
  • Fax:
Mailing address:
  • Phone: 650-278-3696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number27265
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: