Provider Demographics
NPI:1730457177
Name:FRASIER, JOY NADINE (MSW, MA)
Entity type:Individual
Prefix:MRS
First Name:JOY
Middle Name:NADINE
Last Name:FRASIER
Suffix:
Gender:F
Credentials:MSW, MA
Other - Prefix:MRS
Other - First Name:JOY
Other - Middle Name:NADINE
Other - Last Name:WORRELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:P.O. BOX 561
Mailing Address - Street 2:
Mailing Address - City:FORTUNA
Mailing Address - State:CA
Mailing Address - Zip Code:95540
Mailing Address - Country:US
Mailing Address - Phone:707-616-4182
Mailing Address - Fax:
Practice Address - Street 1:220 WILSON LN.
Practice Address - Street 2:
Practice Address - City:FORTUNA
Practice Address - State:CA
Practice Address - Zip Code:95540
Practice Address - Country:US
Practice Address - Phone:707-616-4182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW#27466101YP2500X, 102L00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst