Provider Demographics
NPI:1518456730
Name:COHEN WATERS, GUINA (PHD)
Entity Type:Individual
Prefix:DR
First Name:GUINA
Middle Name:
Last Name:COHEN WATERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2628 VICTOR AVE STE C
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-1454
Mailing Address - Country:US
Mailing Address - Phone:530-953-2330
Mailing Address - Fax:530-953-2335
Practice Address - Street 1:2628 VICTOR AVE STE C
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-1454
Practice Address - Country:US
Practice Address - Phone:530-953-2330
Practice Address - Fax:530-953-2335
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-03
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32541103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY32541OtherCALIFORNIA BOARD OF PSYCHOLOGY