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General NPI Number Information
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NPI Number | 1649481862
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Entity Type | Organization
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Legal Business Name | SUSAN COOK JOSEPHSON, PH.D., INC.
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Dates
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Enumeration Date | 05/28/2007
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Last Update Date | 07/28/2014
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Provider Practice Location Address
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Address Line | 3 POINTE DR SUITE 205
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City | BREA
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State | CA
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Zip | 92821-7624
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Country | US
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Telephone | 714-529-4575
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Fax | 714-529-4575
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Provider Business Mailing Address
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Address Line | 3 POINTE DR SUITE 205
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City | BREA
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State | CA
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Zip | 92821-7624
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Country | US
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Telephone | 714-529-4575
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Fax | 714-529-4575
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUSAN COOK JOSEPHSON
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Credential | PSYCHOLOGIST
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Telephone | 714-529-4575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PSY6970
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License Number State | CA
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