Provider Demographics
NPI:1669511762
Name:COOK, J MAUREEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:J
Middle Name:MAUREEN
Last Name:COOK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JANICE
Other - Middle Name:MAUREEN
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3626 SACRAMENTO ST SUITE 7
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1738
Mailing Address - Country:US
Mailing Address - Phone:415-346-6086
Mailing Address - Fax:415-346-6087
Practice Address - Street 1:3626 SACRAMENTO ST SUITE 7
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1738
Practice Address - Country:US
Practice Address - Phone:415-346-6086
Practice Address - Fax:415-346-6087
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17484103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical