Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY11048 | CA |
N | 103TC1900X | Counseling Psychologist | PSY11048 | CA |
N | 103TM1800X | Intellectual & Developmental Disabilities | PSY11048 | CA |
NPI | 1003868555 |
---|---|
Provider Name | Jeffrey Franz Teuber |
First Address | Sacramento, CA 95814-6414 |
Second Address | Atascadero, CA 93423-7001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 08/07/2007 |