Provider Demographics
NPI:1558665299
Name:OWENS, TERESA (LMFT)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4059 CARMEL VIEW RD UNIT 31
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2351
Mailing Address - Country:US
Mailing Address - Phone:619-373-6429
Mailing Address - Fax:
Practice Address - Street 1:12625 HIGH BLUFF DR STE 107
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2053
Practice Address - Country:US
Practice Address - Phone:619-373-6429
Practice Address - Fax:626-380-4359
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA99418106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist