Healthcare Provider Details

I. General information

NPI: 1851586671
Provider Name (Legal Business Name): TERI ANN POND R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2007
Last Update Date: 09/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 RESEARCH DR
SACRAMENTO CA
95838-3257
US

IV. Provider business mailing address

7001A EAST PKWY
SACRAMENTO CA
95823-2501
US

V. Phone/Fax

Practice location:
  • Phone: 916-648-0991
  • Fax: 916-648-0986
Mailing address:
  • Phone: 916-648-0991
  • Fax: 916-648-0986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number504550
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: