Basic Information
| Provider Information | |||||||||
| NPI: | 1629081138 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN-SIENKO | ||||||||
| FirstName: | TERISA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 S ANAHEIM HILLS RD | ||||||||
| Address2: | #206 | ||||||||
| City: | ANAHEIM HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7142826934 | ||||||||
| FaxNumber: | 7142826935 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 S ANAHEIM HILLS RD | ||||||||
| Address2: | STE #206 | ||||||||
| City: | ANAHEIM HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7142826934 | ||||||||
| FaxNumber: | 7142826935 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2006 | ||||||||
| LastUpdateDate: | 09/12/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 6651 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.