Provider Demographics
NPI:1083266654
Name:OSER, TERESA MICHELLE
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:MICHELLE
Last Name:OSER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TERESA
Other - Middle Name:MICHELLE
Other - Last Name:POIRIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30 PLUME LN STE 2
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:CA
Mailing Address - Zip Code:93514-7075
Mailing Address - Country:US
Mailing Address - Phone:760-937-8961
Mailing Address - Fax:
Practice Address - Street 1:512 W. LINE STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514
Practice Address - Country:US
Practice Address - Phone:760-587-2700
Practice Address - Fax:559-236-3422
Is Sole Proprietor?:No
Enumeration Date:2019-07-12
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94026907103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling