Provider Demographics
NPI:1013168152
Name:HERSCHMAN, TERESA ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:ANN
Last Name:HERSCHMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 AVENIDA PATERO DE ORO
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-3149
Mailing Address - Country:US
Mailing Address - Phone:949-551-2222
Mailing Address - Fax:949-369-1317
Practice Address - Street 1:23421 S POINTE DR
Practice Address - Street 2:103
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1553
Practice Address - Country:US
Practice Address - Phone:949-551-2222
Practice Address - Fax:949-369-1317
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS172651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical