Healthcare Provider Details

I. General information

NPI: 1235787235
Provider Name (Legal Business Name): MS. TARYN ALEXANDRA JOYCE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2019
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 W 7TH ST
SAN PEDRO CA
90731-3320
US

IV. Provider business mailing address

419 ROSS ST
GLENDALE CA
91207-1452
US

V. Phone/Fax

Practice location:
  • Phone: 310-519-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95026084
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number95148159
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number95148159
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: