Healthcare Provider Details

I. General information

NPI: 1598222788
Provider Name (Legal Business Name): KARISSA TERAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2019
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 ROLYN PL
ARCADIA CA
91007-2840
US

IV. Provider business mailing address

401 ROLYN PL
ARCADIA CA
91007-2840
US

V. Phone/Fax

Practice location:
  • Phone: 626-628-7445
  • Fax:
Mailing address:
  • Phone: 626-628-7445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberSAT37502
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: