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General NPI Number Information
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NPI Number | 1508923814
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Entity Type | Individual
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Provider Name | TERESA LEVINSON NP,RN
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Gender | Female
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 5168 HONPIE RD
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City | PLACERVILLE
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State | CA
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Zip | 95667-8635
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Country | US
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Telephone | 530-387-4975
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Fax |
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Provider Business Mailing Address
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Address Line | 2645 NORTHRIDGE DR
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City | PLACERVILLE
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State | CA
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Zip | 95667-3417
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Country | US
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Telephone | 530-409-8882
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 16562
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 16562
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License Number State | CA
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