Healthcare Provider Details

I. General information

NPI: 1326779539
Provider Name (Legal Business Name): MICHAEL BOYD STOKER AMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2022
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 710145
SAN DIEGO CA
92171-0145
US

IV. Provider business mailing address

PO BOX 710145
SAN DIEGO CA
92171-0145
US

V. Phone/Fax

Practice location:
  • Phone: 619-364-4020
  • Fax:
Mailing address:
  • Phone: 619-364-4020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number12261
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number12261
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: