Provider Demographics
NPI:1386313252
Name:JAMES, TESHANA N (PSYD)
Entity type:Individual
Prefix:
First Name:TESHANA
Middle Name:N
Last Name:JAMES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 HURLEY WAY APT 32
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-7349
Mailing Address - Country:US
Mailing Address - Phone:917-596-8771
Mailing Address - Fax:
Practice Address - Street 1:5 MARCIA WAY APT 18
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-7703
Practice Address - Country:US
Practice Address - Phone:917-596-8771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94026156103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical