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General NPI Number Information
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NPI Number | 1154107936
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Entity Type | Individual
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Provider Name | JOSEPHINE GONZALES TEEHANKEE
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Gender | Female
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Dates
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Enumeration Date | 09/06/2023
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 26871 LA SIERRA DR
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6049
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Country | US
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Telephone | 949-305-9024
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Fax | 949-297-8830
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Provider Business Mailing Address
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Address Line | 26871 LA SIERRA DR
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6049
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Country | US
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Telephone | 949-394-2287
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Fax | 949-297-8830
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 450712
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License Number State | CA
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