Marjorie Coburn, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY8758 Issued in CA

Legal business name

MARJORIE COBURN, PH.D.

Doing business as

Phobia and Anxiety Treatment Center

Practice address

836 Prospect St
Suite 101
La Jolla, CA 92037-4213

Phone

(858) 456-5065

NPI assigned

Jun 13, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Marjorie Foster Coburn, PH.D.NPI 1134337066

Title

Clinical Psychologist

Phone

(858) 456-5065

Specialties & licenses 1

Addresses

Other names 1

• Phobia and Anxiety Treatment Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marjorie Coburn, PH.D.

  • Psychologist
  • La Jolla, CA
  • NPI 1134337066
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639373491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 PROSPECT ST",
            "address_2": "SUITE 101",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920374213",
            "telephone_number": "858-456-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PROSPECT ST",
            "address_2": "SUITE 101",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920374213",
            "telephone_number": "858-456-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARJORIE COBURN, PH.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COBURN",
        "authorized_official_first_name": "MARJORIE",
        "authorized_official_middle_name": "FOSTER",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "858-456-5065",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY8758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phobia and Anxiety Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychologist in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.