Individual
MS. CHRISTINE C TELLEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
100 S ELLSWORTH AVE, 303, SAN MATEO, CA 94401-3939
(650) 579-4470
Mailing address
701 LAURELWOOD DR, SAN MATEO, CA 94403-4029
(650) 341-9437
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AU372
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BU187Y
MEDICARE PTAN FOR PENINSULA MEDICAL CLINIC
CA
Enumeration date
01/04/2007
Last updated
12/02/2017
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