Provider Demographics
NPI:1710123880
Name:COX, CHAD K (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:K
Last Name:COX
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8898 NAVAJO RD.
Mailing Address - Street 2:STE C, #316
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-2142
Mailing Address - Country:US
Mailing Address - Phone:619-414-0042
Mailing Address - Fax:
Practice Address - Street 1:5405 MOREHOUSE DR
Practice Address - Street 2:SUITE 120
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-4722
Practice Address - Country:US
Practice Address - Phone:619-414-0042
Practice Address - Fax:855-220-2433
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23320103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CZ023Medicare PIN
CAW416Medicare PIN