Provider Demographics
NPI:1699890939
Name:DECRESCENZO, TERESA ANN (MSW)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:ANN
Last Name:DECRESCENZO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 DONA MARTA DR
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-4326
Mailing Address - Country:US
Mailing Address - Phone:323-654-0724
Mailing Address - Fax:323-654-2055
Practice Address - Street 1:3150 DONA MARTA DR
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-4326
Practice Address - Country:US
Practice Address - Phone:323-654-0724
Practice Address - Fax:323-654-2055
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker