Provider Demographics
NPI:1366574659
Name:SCHULMAN, TERESE G (PHD)
Entity type:Individual
Prefix:DR
First Name:TERESE
Middle Name:G
Last Name:SCHULMAN
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 1:5625 COLLEGE AVE
Mailing Address - Street 2:SUITE 208A
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1585
Mailing Address - Country:US
Mailing Address - Phone:510-655-3975
Mailing Address - Fax:
Practice Address - Street 1:21 TAMAL VISTA BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1130
Practice Address - Country:US
Practice Address - Phone:510-655-3975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 52211041C0700X
CALCSW5221104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical