Provider Demographics
NPI:1417434838
Name:ROMERO, TERESA DE JESUS (RN, CDE)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:DE JESUS
Last Name:ROMERO
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 EL CAJON BLVD
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-5703
Mailing Address - Country:US
Mailing Address - Phone:858-499-2700
Mailing Address - Fax:
Practice Address - Street 1:1380 EL CAJON BLVD
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-5703
Practice Address - Country:US
Practice Address - Phone:858-499-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA659512163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator