MEDICARE: TESLA BORRERO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		CA

General Provider Information

NPI Number	:	1184590606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TESLA BORRERO

Provider Business Mailing Address
First Line	:	1075 CREEKSIDE RIDGE DR STE 280
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95678-3504
Country	:	US
Telephone Number	:	916-729-3098
Fax Number	:

Provider Business Practice Location Address
First Line	:	18 4TH ST
Second Line	:
City	:	MARYSVILLE
State	:	CA
Zip	:	95901-5934
Country	:	US
Telephone Number	:	530-329-9889
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2025
Last Update Date	:	10/13/2025

Similar Medicare Providers

1073466579 — KATIE KIERNAN
Practice Location Address:

726 4TH ST
MARYSVILLE, CA
95901-5656

Practice Phone: 530-749-4300
Practice Fax:

1679189047 — RICHARD THOMAS TAYLOR
Practice Location Address:

825 9TH ST
MARYSVILLE, CA
95901-5265

Practice Phone: 916-676-0488
Practice Fax:

1649721648 — VANDANA CHAUDHARI
Practice Location Address:

5991 LINDHURST AVE
MARYSVILLE, CA
95901-6100

Practice Phone: 530-741-9800
Practice Fax: 530-741-9832

1912124157 — KATRINA HELENE HENRY RN, BSN, PHN
Practice Location Address:

5730 PACKARD AVE STE 100
MARYSVILLE, CA
95901-7117

Practice Phone: 530-749-6393
Practice Fax: 530-749-6397

1033061338 — KARANDEEP KAUR
Practice Location Address:

726 4TH ST
MARYSVILLE, CA
95901-5656

Practice Phone: 530-749-4300
Practice Fax:

1720930522 — STACY E POGUE
Practice Location Address:

5922 LOWE AVE APT 37
MARYSVILLE, CA
95901-6838

Practice Phone: 916-470-7000
Practice Fax: 916-470-7000

Directions to “ TESLA BORRERO ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.