Healthcare Provider Details

I. General information

NPI: 1689728461
Provider Name (Legal Business Name): JOYCE CALDEIRA NCSP,LEP,LMFT,LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2930 CAMINO DIABLO SUITE 100-B
WALNUT CREEK CA
94597-3986
US

IV. Provider business mailing address

2930 CAMINO DIABLO SUITE 100-B
WALNUT CREEK CA
94597-3986
US

V. Phone/Fax

Practice location:
  • Phone: 925-250-3078
  • Fax: 925-954-6755
Mailing address:
  • Phone: 925-250-3078
  • Fax: 925-954-6755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1496
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number050138706
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number2599
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number44136
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: