Provider Demographics
NPI:1629368436
Name:NOORDMANS, TERESA LOUISE (LMFT)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:LOUISE
Last Name:NOORDMANS
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 1:12845 SUNDANCE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2217
Mailing Address - Country:US
Mailing Address - Phone:858-231-7392
Mailing Address - Fax:858-874-8588
Practice Address - Street 1:4998 VIA VALARTA
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92124-1591
Practice Address - Country:US
Practice Address - Phone:858-874-7888
Practice Address - Fax:858-874-8588
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28625106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist