MEDICARE: MS. JOYCE L. MEDLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFC27366	CA

General Provider Information

NPI Number	:	1851407050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOYCE L. MEDLEY

Provider Business Mailing Address
First Line	:	9003 RESEDA BLVD
Second Line	:	SUITE 208
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324-3920
Country	:	US
Telephone Number	:	818-878-1492
Fax Number	:	818-772-2545

Provider Business Practice Location Address
First Line	:	9003 RESEDA BLVD
Second Line	:	SUITE 208
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324-3920
Country	:	US
Telephone Number	:	818-878-1492
Fax Number	:	818-772-2545

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	07/08/2007

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