Healthcare Provider Details

I. General information

NPI: 1700971801
Provider Name (Legal Business Name): TERESA GAIL SAENZ D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 02/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 EL VISTA AVE
MODESTO CA
95354-3006
US

IV. Provider business mailing address

112 EL VISTA AVE
MODESTO CA
95354-3006
US

V. Phone/Fax

Practice location:
  • Phone: 209-526-1284
  • Fax: 209-526-3781
Mailing address:
  • Phone: 209-526-1284
  • Fax: 209-526-3781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number18625
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: