Provider Demographics
NPI:1427036235
Name:HINSON, TERESA (FNP)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:
Last Name:HINSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13223 BLACK MOUNTAIN RD STE 1
Mailing Address - Street 2:123
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2699
Mailing Address - Country:US
Mailing Address - Phone:760-443-4274
Mailing Address - Fax:
Practice Address - Street 1:16773 BERNARDO CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2525
Practice Address - Country:US
Practice Address - Phone:760-443-4274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14125363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
BJ397ZMedicare PIN
CAQ08167Medicare UPIN