Healthcare Provider Details

I. General information

NPI: 1417115239
Provider Name (Legal Business Name): ALICIA MAUREEN TEAUSANT DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2008
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 BRUCEVILLE RD
SACRAMENTO CA
95823-4671
US

IV. Provider business mailing address

8408 ZINNIA WAY
ELK GROVE CA
95624-4221
US

V. Phone/Fax

Practice location:
  • Phone: 916-688-2000
  • Fax:
Mailing address:
  • Phone: 480-993-8767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE5408
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: