Provider Demographics
NPI:1457661555
Name:NEWTON, TENLEY JEAN (TENLEY NEWTONREEGT)
Entity Type:Individual
Prefix:
First Name:TENLEY
Middle Name:JEAN
Last Name:NEWTON
Suffix:
Gender:F
Credentials:TENLEY NEWTONREEGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:746 OCEAN CREST RD
Mailing Address - Street 2:
Mailing Address - City:CARDIFF BY THE SEA
Mailing Address - State:CA
Mailing Address - Zip Code:92007-1337
Mailing Address - Country:US
Mailing Address - Phone:760-230-6598
Mailing Address - Fax:
Practice Address - Street 1:746 OCEAN CREST RD
Practice Address - Street 2:
Practice Address - City:CARDIFF BY THE SEA
Practice Address - State:CA
Practice Address - Zip Code:92007-1337
Practice Address - Country:US
Practice Address - Phone:760-230-6598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASHO149677OtherANTHEM BLUE CROSS BLUE SHIELD