Healthcare Provider Details
I. General information
NPI: 1619350014
Provider Name (Legal Business Name): STEPHANY M. COX PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/02/2015
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3665 KEARNY VILLA RD STE 400
SAN DIEGO CA
92123-1955
US
IV. Provider business mailing address
3020 CHILDRENS WAY # MC5023
SAN DIEGO CA
92123-4223
US
V. Phone/Fax
- Phone: 858-966-5817
- Fax:
- Phone: 858-966-5817
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | PSY29536 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PSY29536 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: