Provider Demographics
NPI:1134290422
Name:OANDASAN, TERESITA ALVIAR (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:TERESITA
Middle Name:ALVIAR
Last Name:OANDASAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5095 HAMPTON CT
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-6687
Mailing Address - Country:US
Mailing Address - Phone:916-791-8207
Mailing Address - Fax:
Practice Address - Street 1:2025 MORSE AVE
Practice Address - Street 2:ANESTHESIA DEPARTMENT 2ND FLOOR
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-2115
Practice Address - Country:US
Practice Address - Phone:916-973-7696
Practice Address - Fax:916-973-6354
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1920367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ14042Medicare UPIN