MEDICARE: TERESA DE LA ROSA 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	104100000X	Social Worker

General Provider Information

NPI Number	:	1285156810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA DE LA ROSA LCSW

Provider Business Mailing Address
First Line	:	2902 E COLLYER LN
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92806-4005
Country	:	US
Telephone Number	:	714-767-6392
Fax Number	:

Provider Business Practice Location Address
First Line	:	14325 GOLDENWEST ST
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-4902
Country	:	US
Telephone Number	:	714-893-1381
Fax Number	:

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

Provider Enumeration Date	:	07/14/2017
Last Update Date	:	06/02/2026

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