Active NPI
Terese Sue Harris, M.D.
- Gynecology Physician
- Huntington Beach, CA
National Provider Identifier
1710163902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- C52490
- Practice address
- 19671 Beach Blvd
Suite315
Huntington Beach, CA 92648-5901 - Phone
- (714) 794-1818
- NPI assigned
- Jan 17, 2008
- Last updated
- Apr 18, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | C52490 | CA | Primary |
Addresses
Primary practice location
19671 Beach Blvd
Suite315
Huntington Beach, CA 92648-5901
Mailing address
19671 Beach Blvd
Suite315
Huntington Beach, CA 92648-5901
Phone (714) 794-1818
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Previously, effective Oct 10, 2016 through Oct 10, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C52490 | CA | MD | Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334707200000",
"number": "1710163902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19671 BEACH BLVD",
"address_2": "SUITE315",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926485901",
"telephone_number": "714-794-1818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19671 BEACH BLVD",
"address_2": "SUITE315",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926485901",
"telephone_number": "714-794-1818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "TERESE",
"middle_name": "SUE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-17",
"last_updated": "2012-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "CA",
"license": "C52490",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.