Individual
ALICIA NICOLE TEFERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
15630 18TH AVE, CLEARLAKE, CA 95422-9336
(707) 994-6486
Mailing address
18836 N SHORE DR, HIDDEN VALLEY LAKE, CA 95467-8630
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A153183
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/16/2016
Last updated
07/28/2021
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