Provider Demographics
NPI:1346418373
Name:LAWTON, TERI (PHD)
Entity Type:Individual
Prefix:DR
First Name:TERI
Middle Name:
Last Name:LAWTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:TERI
Other - Middle Name:
Other - Last Name:BERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 231305
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92023-1305
Mailing Address - Country:US
Mailing Address - Phone:310-903-6009
Mailing Address - Fax:
Practice Address - Street 1:828 SANTA INEZ
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1523
Practice Address - Country:US
Practice Address - Phone:310-903-6009
Practice Address - Fax:858-356-9561
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-12
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA14645900OtherCAQH