Healthcare Provider Details

I. General information

NPI: 1396122057
Provider Name (Legal Business Name): TERI STRAHAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2015
Last Update Date: 03/20/2024
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W E ST
TEHACHAPI CA
93561-1607
US

IV. Provider business mailing address

410 W J ST STE A
TEHACHAPI CA
93561-1411
US

V. Phone/Fax

Practice location:
  • Phone: 661-330-1651
  • Fax:
Mailing address:
  • Phone: 661-822-8979
  • Fax: 661-750-0438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW80182
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: