Provider Demographics
NPI:1538223185
Name:TERESI, KRISHNA ADERO
Entity type:Individual
Prefix:MRS
First Name:KRISHNA
Middle Name:ADERO
Last Name:TERESI
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:KRISHNA
Other - Middle Name:ADERO
Other - Last Name:ALSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 4370
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95617-4370
Mailing Address - Country:US
Mailing Address - Phone:530-400-9231
Mailing Address - Fax:
Practice Address - Street 1:2100 5TH ST
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-6591
Practice Address - Country:US
Practice Address - Phone:530-747-3176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225400000X
CA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner