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General NPI Number Information
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NPI Number | 1134872930
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Entity Type | Individual
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Provider Name | JOY YAGHOUBIAN CADC I
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Gender | Female
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Dates
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Enumeration Date | 02/01/2022
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 69730 HIGHWAY 111 STE 109
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-2873
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Country | US
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Telephone | 760-408-1348
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Fax |
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Provider Business Mailing Address
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Address Line | 74127 CATALINA WAY
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City | PALM DESERT
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State | CA
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Zip | 92260-3004
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Country | US
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Telephone | 760-408-1348
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CI34630122
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License Number State | CA
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