Provider Demographics
NPI:1841953841
Name:TEO, VICTORIA NATALIE (NP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:NATALIE
Last Name:TEO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6139 TEMPLE CITY BLVD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-1748
Mailing Address - Country:US
Mailing Address - Phone:626-348-6817
Mailing Address - Fax:
Practice Address - Street 1:14051 RAMONA PKWY
Practice Address - Street 2:
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-4114
Practice Address - Country:US
Practice Address - Phone:626-960-3753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-16
Last Update Date:2021-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95018859363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily