Provider Demographics
NPI:1114027638
Name:DIONNE, TERESA CHRISITINE (FNP-C, MSN)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:CHRISITINE
Last Name:DIONNE
Suffix:
Gender:F
Credentials:FNP-C, MSN
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:CHRISTINE
Other - Last Name:CUEBA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1695 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-5107
Mailing Address - Country:US
Mailing Address - Phone:408-365-6272
Mailing Address - Fax:
Practice Address - Street 1:710 LAWRENCE EXPY
Practice Address - Street 2:DEPARTMENT 282
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-5173
Practice Address - Country:US
Practice Address - Phone:408-851-2399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA577317163W00000X
CANP16808363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse