Teresa Ethridge

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

24230 Barton Rd
Loma Linda, CA 92354-3232

Phone

(813) 720-9825

NPI assigned

Apr 9, 2024

Last updated

Dec 28, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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

• Humanity Center 4 Change

  • Community Health Worker
  • Rancho Cucamonga, CA
  • NPI 1679320832
  NPD Authorized official
• Heart 2 Heart Unltd LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Loma Linda, CA
  • NPI 1932981453

  Single Specialty

  NPD

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

{
    "created_epoch": "1712620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735344000000",
    "number": "1669225553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 W FLORIDA AVE SPC 688",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925453822",
            "telephone_number": "951-531-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24230 BARTON RD",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543232",
            "telephone_number": "813-720-9825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5001 W Florida Ave Spc 688",
            "address_purpose": "LOCATION",
            "city": "Hemet",
            "state": "CA",
            "postal_code": "925453822",
            "country_code": "US",
            "telephone_number": "951-531-6785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETHRIDGE",
        "first_name": "TERESA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-12-28",
        "certification_date": "2024-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Estes, M.D.
• Ignacio Minguillan Estrada
• Maria De Jesus Estrada
• Ryan Michael Estrada, LVN
• Amanda Leeann Etheridge, M.D.
• James Robert Etteldorf, N.P.
• Evan Hyun-Jin Chung MD Inc
• Nicole Evangelista
• Dwight Charles Evans, M.D.
• Erica Jinhee Evans, MD

• Professional Counselor in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.