Teresa Stevenson, PH.D.

Individual provider Active NPI Clinical Psychologist · Ione, CA

NPI 1629414735 · NPPES record last updated Jul 5, 2013

Key facts

NPI
1629414735
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
PSY13847 (CA)
Practice address
4001 California Highway 104
Ione, CA 95640
Phone
(209) 274-4911
NPI assigned
May 15, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY13847CAMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY13847 CA Yes

Addresses

Primary practice location

4001 California Highway 104
Ione, CA 95640

Mailing address

9102 Generations Dr
Elk Grove, CA 95758-1202
Phone (310) 903-9620

Other providers in Ione, CA

All providers in Ione, CA · Clinical Psychologist in California

Sources for this page

Verify at the official NPI Registry.