Teresa Ethridge
Counselor, Professional in Loma Linda, CA. Individual provider (NPI-1).
NPI number1669225553
StatusActive
Last updated in NPPESDec 28, 2024
Details
- NPI
- 1669225553
- Entity type
- Individual (NPI-1)
- Name
- Teresa Ethridge
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 9, 2024
- Certification date
- Dec 28, 2024
- Last updated
- Dec 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | – | – | Yes |
| 172V00000X | Community Health Worker | – | CA |
Practice location
24230 Barton RdLoma Linda, CA 92354-3232
Phone 813-720-9825
Mailing address
5001 W Florida Ave Spc 688Hemet, CA 92545-3822
Phone 951-531-6785
Other practice locations
5001 W Florida Ave Spc 688
Hemet, CA 92545-3822
Hemet, CA 92545-3822
Phone 951-531-6785
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