Provider Demographics
NPI:1083200976
Name:GEHRI, THERESA NATASHA
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:NATASHA
Last Name:GEHRI
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 1:11132 HERSHEY ST
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-1216
Mailing Address - Country:US
Mailing Address - Phone:213-493-9339
Mailing Address - Fax:
Practice Address - Street 1:11132 HERSHEY ST
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-1216
Practice Address - Country:US
Practice Address - Phone:213-493-9339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32565225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist