Healthcare Provider Details
I. General information
NPI: 1336680875
Provider Name (Legal Business Name): DAWN M TERASHITA, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/16/2017
Last Update Date: 04/30/2025
Certification Date: 02/20/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2233 WATT AVE STE 340
SACRAMENTO CA
95825
US
IV. Provider business mailing address
4343 EAST OUTLIER BLV. SUITE 100W
PHOENIX AZ
85008-6507
US
V. Phone/Fax
- Phone: 877-358-8648
- Fax: 877-877-6875
- Phone: 844-358-8648
- Fax: 877-877-6875
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083P0901X |
| Taxonomy | Public Health & General Preventive Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JUANA
SLACK
Title or Position: MEDICAL BILLING SPECIALIST
Credential:
Phone: 480-646-9086