Healthcare Provider Details

I. General information

NPI: 1992749063
Provider Name (Legal Business Name): TERESA L MEADOWS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 11/03/2022
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 4TH ST FL 6
SAN FRANCISCO CA
94143-2350
US

IV. Provider business mailing address

1825 4TH ST FL 6
SAN FRANCISCO CA
94143-2350
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-2188
  • Fax: 415-502-4867
Mailing address:
  • Phone: 415-476-2188
  • Fax: 415-502-4867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1-119288
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95021498
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: