Healthcare Provider Details

I. General information

NPI: 1912555087
Provider Name (Legal Business Name): STACY ELIZABETH BONDS PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2019
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

374 N COAST HIGHWAY 101
ENCINITAS CA
92024-2542
US

IV. Provider business mailing address

2041 EAST ST STE 1241
CONCORD CA
94520-2126
US

V. Phone/Fax

Practice location:
  • Phone: 858-367-7274
  • Fax:
Mailing address:
  • Phone: 858-208-0380
  • Fax: 833-643-0973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY31084
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: