Provider Demographics
NPI:1366681462
Name:FOSNOT, JAMES RICHARDS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RICHARDS
Last Name:FOSNOT
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:140 MELROSE AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3238
Mailing Address - Country:US
Mailing Address - Phone:760-522-8584
Mailing Address - Fax:760-942-2772
Practice Address - Street 1:317 N EL CAMINO REAL STE 101
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2812
Practice Address - Country:US
Practice Address - Phone:760-522-8584
Practice Address - Fax:760-942-2772
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 17901103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist