Provider Demographics
NPI:1306872502
Name:TESS, MARGARET R (PHD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:R
Last Name:TESS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:R
Other - Last Name:GEILLINGER-TESS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:500 FESLER ST.
Mailing Address - Street 2:STE 205
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-1946
Mailing Address - Country:US
Mailing Address - Phone:619-579-9346
Mailing Address - Fax:619-579-9304
Practice Address - Street 1:500 FESLER ST.
Practice Address - Street 2:STE 205
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-1946
Practice Address - Country:US
Practice Address - Phone:619-579-9346
Practice Address - Fax:619-579-9304
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14628103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY146280Medicaid
CACP14628Medicare PIN