Provider Demographics
NPI:1467007666
Name:GIBOI, COURTNEY JEAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:JEAN
Last Name:GIBOI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2635 CAMINO DEL RIO S STE 302
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3729
Mailing Address - Country:US
Mailing Address - Phone:858-900-9393
Mailing Address - Fax:858-900-9393
Practice Address - Street 1:2635 CAMINO DEL RIO S STE 302
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3729
Practice Address - Country:US
Practice Address - Phone:858-900-9393
Practice Address - Fax:858-900-9393
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA32084103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health