Provider Demographics
NPI:1689947624
Name:HARNDEN, TERESA LINN (MS, RD)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:LINN
Last Name:HARNDEN
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:POINT RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94801-3864
Mailing Address - Country:US
Mailing Address - Phone:510-295-8814
Mailing Address - Fax:
Practice Address - Street 1:401 W RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:POINT RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94801-3864
Practice Address - Country:US
Practice Address - Phone:510-295-8814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA948989133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered