Provider Demographics
NPI:1306384193
Name:COX, TIFFANY (PSYD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:PSYD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 CONNECTICUT AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-1213
Mailing Address - Country:US
Mailing Address - Phone:619-719-1641
Mailing Address - Fax:
Practice Address - Street 1:5400 CONNECTICUT AVE STE 108
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-1213
Practice Address - Country:US
Practice Address - Phone:619-719-1641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-01
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA126862106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist