Healthcare Provider Details

I. General information

NPI: 1245169119
Provider Name (Legal Business Name): RUTHANNE JIA'EN TEO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 S ALMA SCHOOL RD POD A
CHANDLER AZ
85286-7144
US

IV. Provider business mailing address

1435 S ALMA SCHOOL RD POD A
CHANDLER AZ
85286-7144
US

V. Phone/Fax

Practice location:
  • Phone: 480-668-1600
  • Fax:
Mailing address:
  • Phone: 480-668-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: