Provider Demographics
NPI:1205179322
Name:DAROGLOU, STAMATIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:STAMATIA
Middle Name:
Last Name:DAROGLOU
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7946 IVANHOE AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4518
Mailing Address - Country:US
Mailing Address - Phone:619-894-1507
Mailing Address - Fax:
Practice Address - Street 1:7946 IVANHOE AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4516
Practice Address - Country:US
Practice Address - Phone:619-894-1507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20266103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical