Theresa Park, RN, NP

Primary specialty

Community Health/Public Health Clinical Nurse SpecialistTaxonomy code 364SC1501X

License

17824 Issued in CA

Practice address

415 E Chapel St
Santa Maria, CA 93454-4517

Phone

(805) 928-5573

NPI assigned

May 16, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Planned Parenthood Arizona

  • Obstetrics & Gynecology Physician
  • Phoenix, AZ
  • NPI 1083694160
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210896000000",
    "number": "1255598447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 CASTAIC AVE",
            "city": "SHELL BEACH",
            "state": "CA",
            "postal_code": "934491912",
            "telephone_number": "805-295-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E CHAPEL ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934544517",
            "telephone_number": "805-928-5573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "THERESA",
        "credential": "RN, NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-16",
        "last_updated": "2008-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SC1501X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Community Health/Public Health",
            "state": "CA",
            "license": "17824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlotte Ann Park, FNP
• Jae Chang Park, L.A.C.
• Jenna Park
• John Park
• Perla M Park, M.D
• Alexander Parker, DO
• Gina Maria Parker, RN
• Paul Christopher Parker, M.D.
• Rachel Marie Parker
• Sonia Parker, MSN, FNP

• Community Health/Public Health Clinical Nurse Specialist in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Community Health/Public Health Clinical Nurse Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.