Tetra Health Care

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

TETRA HEALTH CARE

Practice address

10714 Woodbine St Apt 4
Los Angeles, CA 90034-5423

Phone

(310) 925-5542

NPI assigned

Nov 15, 2018

Organization subpart

No

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

Authorized official

Name

Geraldine Lise Essombe, BCBA

Title

Bcba

Phone

(310) 925-5542

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542240000000",
    "number": "1396214615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10714 WOODBINE ST APT 4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900345423",
            "telephone_number": "310-925-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10714 WOODBINE ST APT 4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900345423",
            "telephone_number": "310-925-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TETRA HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-15",
        "last_updated": "2018-11-15",
        "status": "A",
        "authorized_official_last_name": "ESSOMBE",
        "authorized_official_first_name": "GERALDINE",
        "authorized_official_middle_name": "LISE",
        "authorized_official_title_or_position": "BCBA",
        "authorized_official_telephone_number": "310-925-5542",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700331956",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Test, OTR/L
• Jason Testa
• Nicholas E Testa, MD
• Testimonial Community Love Center
• Zoe Elizabeth Teton, MD
• Sotirios Tetradis, DDS
• Finnegan Tetrault
• Tyler Allison Tetreault, MD
• Carol B Teutsch, M.D.
• Steven Teutsch, MD, MPH

• Developmentally Disabled Services Day Training Agency in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Developmentally Disabled Services Day Training Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; 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.