Basic Information
| Provider Information | |||||||||
| NPI: | 1669913604 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TOTH | ||||||||
| FirstName: | TERESA | ||||||||
| MiddleName: | L | ||||||||
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| OtherLastName: | COPPIELLIE | ||||||||
| OtherFirstName: | TERESA | ||||||||
| OtherMiddleName: | L | ||||||||
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| OtherCredential: | OTR/L | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1011 PARSONS LNDG | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921545831 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7347320727 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6070 AVENIDA ENCINAS | ||||||||
| Address2: | |||||||||
| City: | CARLSBAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920111001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7604440102 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2017 | ||||||||
| LastUpdateDate: | 03/09/2017 | ||||||||
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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 | 225X00000X | 17012 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.