Provider Demographics
NPI:1326811845
Name:TERAN, YESENIA (LMFT)
Entity Type:Individual
Prefix:
First Name:YESENIA
Middle Name:
Last Name:TERAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79875 BREWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92203-4879
Mailing Address - Country:US
Mailing Address - Phone:760-413-5880
Mailing Address - Fax:
Practice Address - Street 1:79875 BREWOOD WAY
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92203-4879
Practice Address - Country:US
Practice Address - Phone:760-413-5880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA143858106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist