Active NPI
Teresa Koro
- Marriage & Family Therapist
- West Sacramento, CA
National Provider Identifier
1174196869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 1550 Harbor Blvd Ste 200
West Sacramento, CA 95691-3828 - Phone
- (530) 302-5791
- NPI assigned
- Jul 20, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | Primary |
Addresses
Primary practice location
1550 Harbor Blvd Ste 200
West Sacramento, CA 95691-3828
Mailing address
1550 Harbor Blvd Ste 200
West Sacramento, CA 95691-3828
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 4, 2025 through Apr 4, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626739200000",
"number": "1174196869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1550 HARBOR BLVD STE 200",
"city": "WEST SACRAMENTO",
"state": "CA",
"postal_code": "956913828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1550 HARBOR BLVD STE 200",
"city": "WEST SACRAMENTO",
"state": "CA",
"postal_code": "956913828",
"telephone_number": "530-302-5791"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORO",
"first_name": "TERESA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-20",
"last_updated": "2021-07-20",
"certification_date": "2021-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.