Provider Demographics
NPI:1912045477
Name:HOUGEN, TIMOTHY E (PHD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:E
Last Name:HOUGEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39949 CANDY APPLE WAY
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-4766
Mailing Address - Country:US
Mailing Address - Phone:951-240-5770
Mailing Address - Fax:
Practice Address - Street 1:29645 RANCHO CALIFORNIA RD
Practice Address - Street 2:SUITE 109
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-6200
Practice Address - Country:US
Practice Address - Phone:951-240-5770
Practice Address - Fax:951-693-9901
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-04
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15223103TC0700X, 103TC2200X, 103TF0000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103T00000XBehavioral Health & Social Service ProvidersPsychologist