Provider Demographics
NPI:1710032073
Name:HIGGINS, COURTNEY BREWER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:BREWER
Last Name:HIGGINS
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 1:120 MELROSE AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3238
Mailing Address - Country:US
Mailing Address - Phone:760-585-5993
Mailing Address - Fax:
Practice Address - Street 1:169 SAXONY RD
Practice Address - Street 2:STE 211
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-6780
Practice Address - Country:US
Practice Address - Phone:760-585-5993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20761103TC0700X
HIPSY1221103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical