Healthcare Provider Details

I. General information

NPI: 1659556322
Provider Name (Legal Business Name): LAUREL FRAN TERENS PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/31/2007
Last Update Date: 12/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3609 SACRAMENTO ST
SAN FRANCISCO CA
94118-1709
US

IV. Provider business mailing address

3609 SACRAMENTO ST
SAN FRANCISCO CA
94118-1709
US

V. Phone/Fax

Practice location:
  • Phone: 415-922-9940
  • Fax: 415-922-0969
Mailing address:
  • Phone: 415-922-9940
  • Fax: 415-922-0969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY5279
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: