Provider Demographics
NPI:1992802540
Name:FOX, KAREN (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:FOX
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 1:4445 37TH ST
Mailing Address - Street 2:5190 GOVERNOR DR., SUITE 104
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-4602
Mailing Address - Country:US
Mailing Address - Phone:619-563-8876
Mailing Address - Fax:619-330-2746
Practice Address - Street 1:5190 GOVERNOR DR STE 104
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-2848
Practice Address - Country:US
Practice Address - Phone:619-595-3892
Practice Address - Fax:619-330-2746
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14553103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist