Healthcare Provider Details

I. General information

NPI: 1205647906
Provider Name (Legal Business Name): TERRI MINNIEAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2025
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7753 COUNTRY LN
PLEASANTON CA
94566-9744
US

IV. Provider business mailing address

6902 CANTERBURY CIR
HUNTINGTON BEACH CA
92647-2706
US

V. Phone/Fax

Practice location:
  • Phone: 949-791-7828
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number100392
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: