Provider Demographics
NPI:1578924288
Name:ROY, TESSA
Entity Type:Individual
Prefix:
First Name:TESSA
Middle Name:
Last Name:ROY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14636 HORTICULTURAL DR
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-4317
Mailing Address - Country:US
Mailing Address - Phone:413-992-7432
Mailing Address - Fax:
Practice Address - Street 1:8135 PAINTER AVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-3158
Practice Address - Country:US
Practice Address - Phone:562-698-6600
Practice Address - Fax:562-698-6613
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other