Individual provider Active NPI

Romyna Mae Teale

  • Professional Counselor
  • Modesto, CA
National Provider Identifier
1477167518
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
ASW111034 Issued in CA
Practice address
800 Scenic Dr
Modesto, CA 95350-6131
Phone
(209) 525-6201
NPI assigned
Sep 5, 2020
Last updated
Mar 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X ASW111034 CA Primary

Addresses

Primary practice location

800 Scenic Dr
Modesto, CA 95350-6131

Mailing address

3264 Pelandale Ave Apt 9
Modesto, CA 95356-9747
Phone (559) 309-6884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ASW111034CAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1599264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1477167518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 PELANDALE AVE APT 9",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569747",
            "telephone_number": "559-309-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SCENIC DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506131",
            "telephone_number": "209-525-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEALE",
        "first_name": "ROMYNA",
        "middle_name": "MAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-05",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "ASW111034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.