Provider Demographics
NPI:1447355805
Name:KOPLEY, MARGOT B (PSY D)
Entity type:Individual
Prefix:DR
First Name:MARGOT
Middle Name:B
Last Name:KOPLEY
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 230336
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92023-0336
Mailing Address - Country:US
Mailing Address - Phone:760-943-1776
Mailing Address - Fax:760-943-8638
Practice Address - Street 1:2125 EL CAMINO ROAD
Practice Address - Street 2:SUITE 206
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054
Practice Address - Country:US
Practice Address - Phone:760-943-1776
Practice Address - Fax:760-943-8638
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9107103T00000X
NY0077871103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP9107Medicare ID - Type Unspecified