Provider Demographics
NPI:1992727978
Name:FURUKAWA, TERRIE ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:TERRIE
Middle Name:ANN
Last Name:FURUKAWA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 W MICHELTORENA ST
Mailing Address - Street 2:STE. D
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-6522
Mailing Address - Country:US
Mailing Address - Phone:805-564-3715
Mailing Address - Fax:
Practice Address - Street 1:22 W MICHELTORENA ST
Practice Address - Street 2:STE. D
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-6522
Practice Address - Country:US
Practice Address - Phone:805-564-3715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10447103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist