MEDICARE: MRS. HILA TELLER LCSW

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	1041C0700X	Clinical Social Worker	115705	CA

General Provider Information

NPI Number	:	1225710676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HILA TELLER LCSW

Provider Business Mailing Address
First Line	:	737 CHOPIN DR
Second Line	:
City	:	SUNNYVALE
State	:	CA
Zip	:	94087-2812
Country	:	US
Telephone Number	:	408-565-5944
Fax Number	:

Provider Business Practice Location Address
First Line	:	885 N SAN ANTONIO RD STE B
Second Line	:
City	:	LOS ALTOS
State	:	CA
Zip	:	94022-1377
Country	:	US
Telephone Number	:	408-412-1517
Fax Number	:

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

Provider Enumeration Date	:	08/04/2023
Last Update Date	:	08/04/2023

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