Provider Demographics
NPI:1891781415
Name:BANKS, SONJA LEIGH (PHD)
Entity Type:Individual
Prefix:DR
First Name:SONJA
Middle Name:LEIGH
Last Name:BANKS
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 1:9984 SCRIPPS RANCH BLVD # 136
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1825
Mailing Address - Country:US
Mailing Address - Phone:858-212-6060
Mailing Address - Fax:
Practice Address - Street 1:9820 WILLOW CREEK RD STE 245
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1116
Practice Address - Country:US
Practice Address - Phone:858-212-6060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY #15920103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical