Provider Demographics
NPI:1003984519
Name:ENGLAND, TERESA LYNN (MPT)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:LYNN
Last Name:ENGLAND
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:NEWTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7418 MCNEIL WAY
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-1746
Mailing Address - Country:US
Mailing Address - Phone:714-739-2382
Mailing Address - Fax:
Practice Address - Street 1:12465 LEWIS ST
Practice Address - Street 2:SUITE 101
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-4681
Practice Address - Country:US
Practice Address - Phone:714-703-8477
Practice Address - Fax:714-703-8157
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12448225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP18974Medicare UPIN