Provider Demographics
NPI:1467857474
Name:PRICE, TRELOAR (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TRELOAR
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 JUNIPERO AVE
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-4418
Mailing Address - Country:US
Mailing Address - Phone:941-685-0838
Mailing Address - Fax:
Practice Address - Street 1:455 JUNIPERO AVE
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-4418
Practice Address - Country:US
Practice Address - Phone:941-685-0838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-03
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26053103TC0700X
MD05220103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical