Provider Demographics
NPI:1396265815
Name:COHEN, SHEREEN JESSICA (PHD)
Entity type:Individual
Prefix:DR
First Name:SHEREEN
Middle Name:JESSICA
Last Name:COHEN
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 1:1084 N EL CAMINO REAL
Mailing Address - Street 2:SUITE B #172
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1334
Mailing Address - Country:US
Mailing Address - Phone:858-465-6495
Mailing Address - Fax:
Practice Address - Street 1:1084 N EL CAMINO REAL
Practice Address - Street 2:SUITE B #172
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1334
Practice Address - Country:US
Practice Address - Phone:858-465-6495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-26
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33079103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical