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General NPI Number Information
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NPI Number | 1952532152
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Entity Type | Individual
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Provider Name | TERI SPIRITOSANTO MFT
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Gender | Female
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Dates
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Enumeration Date | 08/05/2009
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Last Update Date | 04/26/2014
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Provider Practice Location Address
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Address Line | 2056 LYNDELL TER SUITE 250B
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City | DAVIS
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State | CA
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Zip | 95616-6208
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Country | US
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Telephone | 530-400-1766
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Fax | 530-756-2811
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Provider Business Mailing Address
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Address Line | 3429 MONTEREY AVE
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City | DAVIS
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State | CA
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Zip | 95618-4935
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Country | US
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Telephone | 530-400-1766
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Fax | 530-756-2811
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC53631
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License Number State | CA
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