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Individual

DR. JOHN THOMAS TERRENCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD, PHD

Contact information

Practice address
13900 PANAY WAY, SUITE DS-35, MARINA DEL REY, CA 90292
(310) 821-1589
(310) 821-1589
Mailing address
13900 PANAY WAY, SUITE DS-35, MARINA DEL REY, CA 90292
(310) 821-1589
(310) 821-1589

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
17840
CA

Other

Enumeration date
10/02/2006
Last updated
07/08/2007
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