Healthcare Provider Details

I. General information

NPI: 1922434133
Provider Name (Legal Business Name): MEGAN MELISSA TESKE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2013
Last Update Date: 02/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 STOCKTON BLVD
SACRAMENTO CA
95817-1353
US

IV. Provider business mailing address

2230 STOCKTON BLVD
SACRAMENTO CA
95817-1353
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-7251
  • Fax: 916-734-7539
Mailing address:
  • Phone: 916-734-7251
  • Fax: 916-734-7539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number72818
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: