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General NPI Number Information
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NPI Number | 1598487365
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Entity Type | Individual
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Provider Name | TERESA GAINES
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Gender | Female
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Dates
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Enumeration Date | 09/16/2022
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Last Update Date | 09/16/2022
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Provider Practice Location Address
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Address Line | 22225 FOOTHILL BLVD
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City | HAYWARD
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State | CA
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Zip | 94541-2712
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Country | US
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Telephone | 510-265-8207
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Fax |
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Provider Business Mailing Address
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Address Line | 96 LINDA AVE APT 4
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City | PIEDMONT
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State | CA
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Zip | 94611-4838
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Country | US
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Telephone | 707-652-4425
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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