Provider Demographics
NPI:1780891788
Name:QUATMAN, TERI (PHD)
Entity type:Individual
Prefix:DR
First Name:TERI
Middle Name:
Last Name:QUATMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:TERI
Other - Middle Name:
Other - Last Name:QUATMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:TERI QUATMAN
Mailing Address - Street 1:419 BUNDY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117-1642
Mailing Address - Country:US
Mailing Address - Phone:408-261-0505
Mailing Address - Fax:408-261-0500
Practice Address - Street 1:419 BUNDY AVE.
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95117-1642
Practice Address - Country:US
Practice Address - Phone:408-261-0500
Practice Address - Fax:408-261-0505
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12737103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis