Provider Demographics
NPI:1437346525
Name:CURRIVAN, TERESA YVONNE (MFTI)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:YVONNE
Last Name:CURRIVAN
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44000 OLD WARM SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-6145
Mailing Address - Country:US
Mailing Address - Phone:510-468-1323
Mailing Address - Fax:510-897-6909
Practice Address - Street 1:44000 OLD WARM SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-6145
Practice Address - Country:US
Practice Address - Phone:510-468-1323
Practice Address - Fax:510-897-6909
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAIMF 60060101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health