Provider Demographics
NPI:1154107936
Name:TEEHANKEE, JOSEPHINE GONZALES
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:GONZALES
Last Name:TEEHANKEE
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 1:26871 LA SIERRA DR
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6049
Mailing Address - Country:US
Mailing Address - Phone:949-394-2287
Mailing Address - Fax:949-297-8830
Practice Address - Street 1:26871 LA SIERRA DR
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6049
Practice Address - Country:US
Practice Address - Phone:949-305-9024
Practice Address - Fax:949-297-8830
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA450712163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice