Healthcare Provider Details

I. General information

NPI: 1053837260
Provider Name (Legal Business Name): JOY KIYOMI LE PAGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2017
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13541 MERKEL AVENUE
PARAMOUNT CA
90723-2338
US

IV. Provider business mailing address

6074 MYRA AVE
BUENA PARK CA
90620-4337
US

V. Phone/Fax

Practice location:
  • Phone: 562-602-8056
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: