Provider Demographics
NPI:1467516559
Name:COONS, STEPHANIE (PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:COONS
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 1:190 AVENIDA MAJORCA UNIT C
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92637-6742
Mailing Address - Country:US
Mailing Address - Phone:949-677-1278
Mailing Address - Fax:949-454-0992
Practice Address - Street 1:27001 LA PAZ RD STE 260
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5524
Practice Address - Country:US
Practice Address - Phone:949-677-1278
Practice Address - Fax:949-454-0992
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19187103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist