MEDICARE: DR. KAREN FOX 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	103T00000X	Psychologist	PSY14553	CA

General Provider Information

NPI Number	:	1992802540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN FOX PH.D

Provider Business Mailing Address
First Line	:	4445 37TH ST
Second Line	:	5190 GOVERNOR DR., SUITE 104
City	:	SAN DIEGO
State	:	CA
Zip	:	92116-4602
Country	:	US
Telephone Number	:	619-563-8876
Fax Number	:	619-330-2746

Provider Business Practice Location Address
First Line	:	5190 GOVERNOR DR STE 104
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122-2848
Country	:	US
Telephone Number	:	619-595-3892
Fax Number	:	619-330-2746

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

Provider Enumeration Date	:	09/17/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. KAREN FOX PH.D” Practice Location

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