Provider Demographics
NPI:1255706362
Name:JAMES, TERESA CASSANDRA
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:CASSANDRA
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:CASSANDRA
Other - Last Name:BARLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1365 N JOHNSON AVE
Mailing Address - Street 2:111
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-1676
Mailing Address - Country:US
Mailing Address - Phone:619-440-4801
Mailing Address - Fax:619-442-1592
Practice Address - Street 1:1365 N JOHNSON AVE
Practice Address - Street 2:111
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-1676
Practice Address - Country:US
Practice Address - Phone:619-440-4801
Practice Address - Fax:619-442-1592
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)