Provider Demographics
NPI:1215975479
Name:COHEN, NANCY RAE (MD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:RAE
Last Name:COHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3170 VIA DE CABALLO
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-6925
Mailing Address - Country:US
Mailing Address - Phone:480-518-4140
Mailing Address - Fax:
Practice Address - Street 1:3170 VIA DE CABALLO
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-6925
Practice Address - Country:US
Practice Address - Phone:480-518-4140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2017-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG1320142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry