Provider Demographics
NPI:1225404601
Name:SMITHSON, TERESA (ASWC)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:SMITHSON
Suffix:
Gender:F
Credentials:ASWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-2532
Mailing Address - Country:US
Mailing Address - Phone:805-237-0992
Mailing Address - Fax:805-237-0993
Practice Address - Street 1:1140 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-2532
Practice Address - Country:US
Practice Address - Phone:805-237-0992
Practice Address - Fax:805-237-0993
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW291761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical