Individual
MR. TIMOTHY LATERREUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHMNP
Contact information
Practice address
3930 4TH AVE STE 300, SAN DIEGO, CA 92103-3119
(619) 920-3084
Mailing address
3930 4TH AVE STE 300, SAN DIEGO, CA 92103-3119
(619) 920-3084
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95037146
CA
Other
Enumeration date
09/23/2025
Last updated
10/24/2025
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