Healthcare Provider Details

I. General information

NPI: 1144743550
Provider Name (Legal Business Name): JOYCE DENESE MAYZCK LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2017
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10850 MACARTHUR BLVD STE 200
OAKLAND CA
94605-5266
US

IV. Provider business mailing address

PO BOX 8324
EMERYVILLE CA
94662-0324
US

V. Phone/Fax

Practice location:
  • Phone: 510-875-2300
  • Fax: 510-875-2310
Mailing address:
  • Phone: 650-455-7884
  • Fax: 510-875-2310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number16824
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: