Provider Demographics
NPI:1154619955
Name:LOCASCIO, TERESA ANN (LMFT)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:ANN
Last Name:LOCASCIO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 TRESCONY ST APT B
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-4735
Mailing Address - Country:US
Mailing Address - Phone:702-575-0264
Mailing Address - Fax:
Practice Address - Street 1:107 PAULINE DR
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-1063
Practice Address - Country:US
Practice Address - Phone:025-304-3207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-13
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
CA109834106H00000X
CA133404106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker