Provider Demographics
NPI:1730547233
Name:ATKINS, TERRY
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:ATKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2931 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-1025
Mailing Address - Country:US
Mailing Address - Phone:925-676-4840
Mailing Address - Fax:
Practice Address - Street 1:2931 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-1025
Practice Address - Country:US
Practice Address - Phone:925-676-4840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-29
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist