Healthcare Provider Details
I. General information
NPI: 1174885396
Provider Name (Legal Business Name): CHRISTIE ALYCE JOYA D.O., FACP, MTM&H
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/13/2012
Last Update Date: 08/22/2022
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
620 JOHN PAUL JONES CIR
PORTSMOUTH VA
23708-2111
US
IV. Provider business mailing address
620 JOHN PAUL JONES CIR STE 275
PORTSMOUTH VA
23708-2197
US
V. Phone/Fax
- Phone: 757-953-5179
- Fax: 757-953-7674
- Phone: 757-953-5179
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171000000X |
| Taxonomy | Military Health Care Provider |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 13244 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | 390200000 |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | 13244 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: