Provider Demographics
NPI:1538523840
Name:ALDERSON, TERI (RN)
Entity type:Individual
Prefix:
First Name:TERI
Middle Name:
Last Name:ALDERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TERI
Other - Middle Name:LYNN
Other - Last Name:BRIDGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28201 MARGUERITE PKWY STE 13
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-3719
Mailing Address - Country:US
Mailing Address - Phone:949-364-3928
Mailing Address - Fax:
Practice Address - Street 1:28201 MARGUERITE PKWY STE 13
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-3719
Practice Address - Country:US
Practice Address - Phone:949-364-3928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95075284163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33-0150193OtherMEDI-CAL