Provider Demographics
NPI:1578749487
Name:TESKA, RICHARD
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:TESKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45550 GRACE ST
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-4610
Mailing Address - Country:US
Mailing Address - Phone:760-342-1233
Mailing Address - Fax:760-342-5344
Practice Address - Street 1:1445 N SUNRISE WAY STE 103
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-3700
Practice Address - Country:US
Practice Address - Phone:760-322-4554
Practice Address - Fax:760-342-5344
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)