Individual
THERESA SIVERS-TEIXEIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
625 SOUTH FAIR OAKS, #400, PASADENA, CA 91105
(626) 568-1622
(626) 865-9560
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-5900
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
23192
CA
363AM0700X
Medical Physician Assistant
Primary
PA23192
CA
Other
Enumeration date
01/15/2014
Last updated
11/27/2023
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