Doctor Name: | DR. TERESA BAILEY |
NPI Number: | 1063757847 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D., PH.D. |
License Number: | PSY17586 |
Business Practice Address: | 881 Fremont Ave Suite B Los Altos, CA - 940245697 |
Business Phone Number: | 6509673451 |
Business Fax Number: | |
Mailing Address: | Po Box 4058, LOS ALTOS |
State: | CA |
Postal Code: | 940241058 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/04/2012 |
NPI Last Update Date: | 12/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | PSY17586 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |