Healthcare Provider Details

I. General information

NPI: 1265343347
Provider Name (Legal Business Name): EMBRACE FUNCTIONAL WELLNESS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5764 SAN VICENTE BLVD APT 402
LOS ANGELES CA
90019-7009
US

IV. Provider business mailing address

5764 SAN VICENTE BLVD APT 402
LOS ANGELES CA
90019-7009
US

V. Phone/Fax

Practice location:
  • Phone: 626-510-2730
  • Fax:
Mailing address:
  • Phone: 626-510-2730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: TERESA L TENG
Title or Position: OWNER
Credential: OTD, OTR/L, CLT
Phone: 626-510-2730