MEDICARE: DR. RENEE A JOSEPH PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	261QM0850X	Adult Mental Health Clinic/Center
3	103TC0700X	Clinical Psychologist	PSY35781	CA

General Provider Information

NPI Number	:	1033701552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RENEE A JOSEPH PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 3173
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92163-1173
Country	:	US
Telephone Number	:	347-513-7261
Fax Number	:

Provider Business Practice Location Address
First Line	:	14750 EL CAMINO REAL
Second Line	:
City	:	DEL MAR
State	:	CA
Zip	:	92014-4204
Country	:	US
Telephone Number	:	858-904-1911
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2021
Last Update Date	:	09/10/2025

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