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General NPI Number Information
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NPI Number | 1114722410
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Entity Type | Individual
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Provider Name | TERESITA ARDONA ENRIQUEZ FNP
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Gender | Female
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Dates
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Enumeration Date | 02/19/2025
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 1900 SULLIVAN AVE
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City | DALY CITY
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State | CA
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Zip | 94015-2200
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Country | US
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Telephone | 650-992-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 1145 ALAMEDA DE LAS PULGAS APT 18
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City | BELMONT
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State | CA
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Zip | 94002-3502
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Country | US
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Telephone | 707-648-6376
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95033886
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License Number State | CA
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