Healthcare Provider Details

I. General information

NPI: 1902011950
Provider Name (Legal Business Name): ANNEMARIE STOKES PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4649 60TH ST
SAN DIEGO CA
92115-3825
US

IV. Provider business mailing address

4649 60TH ST
SAN DIEGO CA
92115-3825
US

V. Phone/Fax

Practice location:
  • Phone: 619-222-2343
  • Fax:
Mailing address:
  • Phone: 619-222-2343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: