Provider Demographics
NPI:1700766904
Name:AUXILIUM EDUCATIONAL PSYCHOLOGY, PC
Entity type:Organization
Organization Name:AUXILIUM EDUCATIONAL PSYCHOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EDUCATIONAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, EDS, LEP
Authorized Official - Phone:831-206-0904
Mailing Address - Street 1:207 HARVEST ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3310
Mailing Address - Country:US
Mailing Address - Phone:831-206-0904
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:207 HARVEST ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3310
Practice Address - Country:US
Practice Address - Phone:831-206-0904
Practice Address - Fax:000-000-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty