Provider Demographics
NPI:1649481862
Name:SUSAN COOK JOSEPHSON, PH.D., INC.
Entity type:Organization
Organization Name:SUSAN COOK JOSEPHSON, PH.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:COOK
Authorized Official - Last Name:JOSEPHSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYCHOLOGIST
Authorized Official - Phone:714-529-4575
Mailing Address - Street 1:3 POINTE DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-7624
Mailing Address - Country:US
Mailing Address - Phone:714-529-4575
Mailing Address - Fax:714-529-4575
Practice Address - Street 1:3 POINTE DR
Practice Address - Street 2:SUITE 205
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-7624
Practice Address - Country:US
Practice Address - Phone:714-529-4575
Practice Address - Fax:714-529-4575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6970251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health