Provider Demographics
NPI:1831914852
Name:ORENCE-FIERRO, TEAYANA M
Entity type:Individual
Prefix:
First Name:TEAYANA
Middle Name:M
Last Name:ORENCE-FIERRO
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 1:5 ROCKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-4725
Mailing Address - Country:US
Mailing Address - Phone:415-990-8471
Mailing Address - Fax:
Practice Address - Street 1:504 NORTHBANK CT APT 143
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-7650
Practice Address - Country:US
Practice Address - Phone:415-990-8471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician