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General NPI Number Information
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NPI Number | 1679620264
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Entity Type | Individual
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Provider Name | CHRISTINE C TELLEEN M.A.
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Gender | Female
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 12/02/2017
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Provider Practice Location Address
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Address Line | 100 S ELLSWORTH AVE 303
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City | SAN MATEO
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State | CA
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Zip | 94401-3939
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Country | US
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Telephone | 650-579-4470
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Fax |
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Provider Business Mailing Address
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Address Line | 701 LAURELWOOD DR
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City | SAN MATEO
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State | CA
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Zip | 94403-4029
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Country | US
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Telephone | 650-341-9437
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AU372
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License Number State | CA
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