Provider Demographics
NPI:1376754580
Name:JOSEPHSON, SUSAN COOK (PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:COOK
Last Name:JOSEPHSON
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3 POINTE DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-3651
Mailing Address - Country:US
Mailing Address - Phone:714-529-4575
Mailing Address - Fax:
Practice Address - Street 1:3 POINTE DR
Practice Address - Street 2:SUITE 205
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-3651
Practice Address - Country:US
Practice Address - Phone:714-529-4575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6970103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical