Healthcare Provider Details

I. General information

NPI: 1346155090
Provider Name (Legal Business Name): HANNAH TEDESCO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

657 ALCATRAZ AVE
OAKLAND CA
94609-1005
US

IV. Provider business mailing address

657 ALCATRAZ AVE
OAKLAND CA
94609-1005
US

V. Phone/Fax

Practice location:
  • Phone: 707-235-9709
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number141187
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: