Provider Demographics
NPI:1063541118
Name:HELBERG, TERRIE JOLENE (MFC37894)
Entity type:Individual
Prefix:MS
First Name:TERRIE
Middle Name:JOLENE
Last Name:HELBERG
Suffix:
Gender:F
Credentials:MFC37894
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 LOWELL AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-2449
Mailing Address - Country:US
Mailing Address - Phone:626-335-4683
Mailing Address - Fax:
Practice Address - Street 1:902 S MYRTLE AVE FL 2
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-3427
Practice Address - Country:US
Practice Address - Phone:626-357-3258
Practice Address - Fax:626-301-0868
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37894106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist