Provider Demographics
NPI:1871293860
Name:OAKLEY, TERESA BASILLA
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:BASILLA
Last Name:OAKLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1622 BARTOW RD
Mailing Address - Street 2:
Mailing Address - City:MCKINLEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95519-4309
Mailing Address - Country:US
Mailing Address - Phone:707-496-9425
Mailing Address - Fax:
Practice Address - Street 1:1622 BARTOW RD
Practice Address - Street 2:
Practice Address - City:MCKINLEYVILLE
Practice Address - State:CA
Practice Address - Zip Code:95519-4309
Practice Address - Country:US
Practice Address - Phone:707-496-9425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other