Joy Helene Cordaway

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

41020 Issued in CA

Practice address

1212 N California St
Stockton, CA 95202-1552

Phone

(209) 561-4484

NPI assigned

Mar 24, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1316574098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 CALIFORNIA ST.",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95336",
            "telephone_number": "209-561-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021552",
            "telephone_number": "209-561-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDAWAY",
        "first_name": "JOY",
        "middle_name": "HELENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "41020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167G00000X",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Joy202608@gmailcom",
            "affiliation": "N",
            "endpointDescription": "Joy202608@gmail.com",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1212 N California St",
            "city": "Stockton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "952021552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy Marie Coppel
• Johnna Coppock, RD
• Coral Dialysis LLC (Port City Dialysis)
• Sharon Corbin, APRN
• Tyera Cord
• Giyana Elizabeth Cordero
• Marie Anthonie Peralta Cordero
• Susan R Cordes, M.D.
• Carol S Cordier-Carpenter
• Catina Louise Cordova-Ramirez

• Licensed Psychiatric Technician in Stockton, CA
• Providers in Stockton, CA by specialty
• Licensed Psychiatric Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.