Provider Demographics
NPI:1104894450
Name:TEEGARDEN, BETH ANN (DO)
Entity type:Individual
Prefix:DR
First Name:BETH
Middle Name:ANN
Last Name:TEEGARDEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5122 WHITMAN WAY APT 201
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-4652
Mailing Address - Country:US
Mailing Address - Phone:918-645-9717
Mailing Address - Fax:
Practice Address - Street 1:5122 WHITMAN WAY APT 201
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-4652
Practice Address - Country:US
Practice Address - Phone:918-645-9717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-11
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK35902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry