Provider Demographics
NPI:1760515605
Name:FLORATOS, TERESA ANN (MFT)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:ANN
Last Name:FLORATOS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3175 SUNSET BLVD STE 104A
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-3091
Mailing Address - Country:US
Mailing Address - Phone:916-624-8626
Mailing Address - Fax:
Practice Address - Street 1:3175 SUNSET BLVD STE 104A
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-3091
Practice Address - Country:US
Practice Address - Phone:916-624-8626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45029106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist