1669677951 NPI number — TERESA MEISENHALDER PSYCHOMETRIST

Table of content: TERESA MEISENHALDER PSYCHOMETRIST (NPI 1669677951)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669677951 NPI number — TERESA MEISENHALDER PSYCHOMETRIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEISENHALDER
Provider First Name:
TERESA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PSYCHOMETRIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669677951
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 555657
Provider Second Line Business Mailing Address:
1ST MEDICAL BATTALION, 22 GAS
Provider Business Mailing Address City Name:
CAMP PENDLETON
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92055-5657
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-725-4912
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2739T ROOSEVELT DR
Provider Second Line Business Practice Location Address:
BLDG H201-T
Provider Business Practice Location Address City Name:
CAMP PENDLETON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92055-5657
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
519-514-8294
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1710I1002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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