Healthcare Provider Details

I. General information

NPI: 1558830208
Provider Name (Legal Business Name): IRENE TENEFF RESP. THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: IRENE TENEFF CONNER

II. Dates (important events)

Enumeration Date: 11/23/2018
Last Update Date: 11/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 LAWRENCE EXPY
SANTA CLARA CA
95051-5173
US

IV. Provider business mailing address

1344 MALLARD CREEK CT
PATTERSON CA
95363-8756
US

V. Phone/Fax

Practice location:
  • Phone: 408-851-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number11670
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: