Provider Demographics
NPI:1811082308
Name:FOX, ERIK LEE (PHD)
Entity type:Individual
Prefix:DR
First Name:ERIK
Middle Name:LEE
Last Name:FOX
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9850 GENESEE AVE.
Mailing Address - Street 2:SUITE 910
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037
Mailing Address - Country:US
Mailing Address - Phone:619-279-2472
Mailing Address - Fax:413-208-0592
Practice Address - Street 1:9850 GENESEE AVE.
Practice Address - Street 2:SUITE 910
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:619-279-2472
Practice Address - Fax:413-208-0592
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14738103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY147380OtherMEDI-CAL
CACP14738Medicare ID - Type UnspecifiedPSYCHOLOGIST