Provider Demographics
NPI:1801148556
Name:BAUGH, TERENCE ALEXANDER
Entity type:Individual
Prefix:
First Name:TERENCE
Middle Name:ALEXANDER
Last Name:BAUGH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 BOARDMAN PL
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-4729
Mailing Address - Country:US
Mailing Address - Phone:415-621-5661
Mailing Address - Fax:
Practice Address - Street 1:424 GUERRERO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1015
Practice Address - Country:US
Practice Address - Phone:415-793-2763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-04
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist