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Individual

DR. JOSE MARCOS LAFOSSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
4080 CENTRE ST STE 104, SAN DIEGO, CA 92103-2655
(858) 964-0722
(866) 437-0375
Mailing address
4251 KIPLING ST, UNIT 565, WHEAT RIDGE, CO 80033-2899
(720) 965-0055
(720) 799-0383

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
2278
CO
103TB0200X
Cognitive & Behavioral Psychologist
2278
CO
103TC0700X
Clinical Psychologist
2278
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2278
STATE LICENSE
CO
Enumeration date
05/24/2007
Last updated
08/01/2022
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