Provider Demographics
NPI:1316618457
Name:COX, DELILAH ANICIA
Entity type:Individual
Prefix:
First Name:DELILAH
Middle Name:ANICIA
Last Name:COX
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:PERRY
Other - Middle Name:ANICIA
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3930 GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-3505
Mailing Address - Country:US
Mailing Address - Phone:619-306-1084
Mailing Address - Fax:
Practice Address - Street 1:4025 CAMINO DEL RIO S STE 101
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4100
Practice Address - Country:US
Practice Address - Phone:818-241-6780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician