1821340100 NPI number — TERESA ANN TESTA

Table of content: TERESA ANN TESTA (NPI 1821340100)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821340100 NPI number — TERESA ANN TESTA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TESTA
Provider First Name:
TERESA
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821340100
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/29/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
325 DISTEL CIR FL 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ALTOS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94022-1408
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-523-3910
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1085 W EL CAMINO REAL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUNNYVALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94087-1030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-523-3910
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/10/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 237600000X , with the licence number:  HT 8908 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237600000X , with the licence number: RPE 7889 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: RPE 7889 . This is a "SPEECH-LANGUAGE PATHOLOGY, AUDIOLOGY & HEARING AID DISPENSERS BOARD" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: HT 8908 . This is a "SPEECH-LANGUAGE PATHOLOGY, AUDIOLOGY & HEARING AID DISPENSERS BOARD" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".