Provider Demographics
NPI:1922652619
Name:LEON, TERESA CORTEZ
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:CORTEZ
Last Name:LEON
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 1:30 E SAN JOAQUIN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2946
Mailing Address - Country:US
Mailing Address - Phone:831-424-5033
Mailing Address - Fax:831-424-5044
Practice Address - Street 1:30 E SAN JOAQUIN ST STE 102
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2946
Practice Address - Country:US
Practice Address - Phone:831-424-5033
Practice Address - Fax:831-424-5044
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator