Provider Demographics
NPI:1821440645
Name:OEHLER, TERRA (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:TERRA
Middle Name:
Last Name:OEHLER
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4605 VIA GIARDIANO
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95357-0661
Mailing Address - Country:US
Mailing Address - Phone:209-900-3722
Mailing Address - Fax:209-545-1468
Practice Address - Street 1:5716 PIRRONE RD
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CA
Practice Address - Zip Code:95368
Practice Address - Country:US
Practice Address - Phone:209-545-1440
Practice Address - Fax:209-545-1468
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-16-22269103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst