Provider Demographics
NPI:1780846162
Name:MCPHERSON, TERRI LYNN
Entity Type:Individual
Prefix:MS
First Name:TERRI
Middle Name:LYNN
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TERRI
Other - Middle Name:LYNN
Other - Last Name:SORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2495 W MARCH LN
Mailing Address - Street 2:SUITE 125
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-8251
Mailing Address - Country:US
Mailing Address - Phone:209-465-1080
Mailing Address - Fax:
Practice Address - Street 1:2495 W MARCH LN
Practice Address - Street 2:SUITE 125
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-8251
Practice Address - Country:US
Practice Address - Phone:209-465-1080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAN/A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health