Provider Demographics
NPI:1144887530
Name:ONEILL, TERESA ANN (NP)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:ANN
Last Name:ONEILL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 TOWN CTR W STE 101
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-5076
Mailing Address - Country:US
Mailing Address - Phone:805-922-6581
Mailing Address - Fax:
Practice Address - Street 1:361 TOWN CTR W STE 101
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-5076
Practice Address - Country:US
Practice Address - Phone:805-922-6581
Practice Address - Fax:805-332-3900
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95011673363L00000X
CA223872881363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1386971687Medicaid