Provider Demographics
NPI:1295956324
Name:TEPPERMAN, MARGOT E (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MARGOT
Middle Name:E
Last Name:TEPPERMAN
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 1:171 N VAN NESS AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93701-1671
Mailing Address - Country:US
Mailing Address - Phone:559-233-7250
Mailing Address - Fax:559-233-9126
Practice Address - Street 1:171 N VAN NESS AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-1671
Practice Address - Country:US
Practice Address - Phone:559-233-7250
Practice Address - Fax:559-233-9126
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS92671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ16229ZMedicare ID - Type UnspecifiedMEDICARE NUMBER