Provider Demographics
NPI:1003296815
Name:SHKVARCHUK, TERESA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:TERESA
Middle Name:
Last Name:SHKVARCHUK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6333 FLORIO ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1335
Mailing Address - Country:US
Mailing Address - Phone:415-425-0963
Mailing Address - Fax:
Practice Address - Street 1:6333 FLORIO ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1335
Practice Address - Country:US
Practice Address - Phone:415-425-0963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-05
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP16571235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist