Provider Demographics
NPI:1801077102
Name:ELMORE, JOYCE CAROL (PSY D)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:CAROL
Last Name:ELMORE
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:DR
Other - First Name:JOYCE
Other - Middle Name:CAROL
Other - Last Name:ELMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSY D
Mailing Address - Street 1:1151 HARBOR BAY PKWY
Mailing Address - Street 2:SUITE 113
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94502-6540
Mailing Address - Country:US
Mailing Address - Phone:510-337-0400
Mailing Address - Fax:510-337-9502
Practice Address - Street 1:1151 HARBOR BAY PKWY
Practice Address - Street 2:SUITE 113
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94502-6540
Practice Address - Country:US
Practice Address - Phone:510-337-0400
Practice Address - Fax:510-337-9502
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21692103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist