Provider Demographics
NPI:1780461012
Name:TERRY, BILLIE JEAN
Entity type:Individual
Prefix:
First Name:BILLIE
Middle Name:JEAN
Last Name:TERRY
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 1:401 GRAND AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-5056
Mailing Address - Country:US
Mailing Address - Phone:415-605-5572
Mailing Address - Fax:
Practice Address - Street 1:24301 SOUTHLAND DR STE 600
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-1554
Practice Address - Country:US
Practice Address - Phone:510-417-9889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty