Provider Demographics
NPI:1508988346
Name:JENSEN, TERESA (MD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:JENSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2827 STERNE PL
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-1425
Mailing Address - Country:US
Mailing Address - Phone:510-793-4877
Mailing Address - Fax:
Practice Address - Street 1:300 HOSPITAL DR
Practice Address - Street 2:SUTTER SOLANO MEDICAL CENTER
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2574
Practice Address - Country:US
Practice Address - Phone:707-333-5059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA067192207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology