Provider Demographics
NPI:1033935259
Name:FOX, MEGAN JEAN (ASW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:JEAN
Last Name:FOX
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 S MARKET ST APT 1410
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95113-1777
Mailing Address - Country:US
Mailing Address - Phone:714-915-1076
Mailing Address - Fax:
Practice Address - Street 1:1650 S WHITE RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-4758
Practice Address - Country:US
Practice Address - Phone:408-928-5250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA919671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical