MEDICARE: TERESA HUANG RN, MSN, FNP, CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	714512	CA
2	367500000X	Certified Registered Nurse Anesthetist	95000382	CA

General Provider Information

NPI Number	:	1205221231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA HUANG RN, MSN, FNP, CRNA

Provider Business Mailing Address
First Line	:	215 BLUFF DR
Second Line	:
City	:	LOWELL
State	:	AR
Zip	:	72745-9108
Country	:	US
Telephone Number	:	626-808-1276
Fax Number	:

Provider Business Practice Location Address
First Line	:	3440 E LA PALMA AVE
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92806-2020
Country	:	US
Telephone Number	:	714-644-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2015
Last Update Date	:	04/10/2026

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