Individual provider Active NPI

Teresa Elizabeth Teacher, LCSW

  • Clinical Social Worker
  • Moreno Valley, CA
National Provider Identifier
1356521579
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
79474 Issued in CA
Practice address
27120 Eucalyptus Ave # 435
Moreno Valley, CA 92555-4543
Phone
(773) 617-0566
Fax
(626) 639-3241
NPI assigned
Nov 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 79474 CA Primary

Addresses

Primary practice location

27120 Eucalyptus Ave # 435
Moreno Valley, CA 92555-4543

Mailing address

8122 S Saint Lawrence Ave
Chicago, IL 60619-5008
Phone (773) 617-0566

Other names 1

  • Teresa Teacher Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200825002475 CA Practitioner - Clinical Social Worker 4789005075 Reassigns benefits to 1 organization
Practice locations: Pasadena, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
79474CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Memory Check Psychological Services, a Professional Corporation Clinical CurrentSince Aug 18, 2025 Accepting new patients

Locations

1902 Wright Pl
Fl 2
Carlsbad, CA 92008
Phone (929) 468-2465

5838 Edison Pl
Ste 100
Carlsbad, CA 92008
Phone (760) 300-3664

348 Iris Dr
Salinas, CA 93906
Phone (831) 449-5496

7447 Sepulveda Blvd
Van Nuys, CA 91405
Phone (818) 787-3400

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1356521579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8122 S SAINT LAWRENCE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606195008",
            "telephone_number": "773-617-0566",
            "fax_number": "626-639-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27120 EUCALYPTUS AVE # 435",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925554543",
            "telephone_number": "773-617-0566",
            "fax_number": "626-639-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEACHER",
        "first_name": "TERESA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-05",
        "last_updated": "2025-04-02",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "79474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "TEACHER",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.