TERESA MAHONEY FADELY ACNP NPI 1821214024

NPI Information

  • NPI: 1821214024
  • Provider Name: TERESA MAHONEY FADELY, ACNP
  • Classification: Nurse Practitioner - 363LA2100X
  • Specialization: Acute Care
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 200 UCLA MEDICAL PLZ
    STE B265
    LOS ANGELES, CA
    ZIP 90095
  • Phone: (310) 825-0128

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NPI Details

Teresa Mahoney Fadely, ACNP is an acute care nurse practitioner in Los Angeles, CA. Teresa Mahoney Fadely, ACNP NPI is 1821214024. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

200 UCLA MEDICAL PLZ
STE B265
LOS ANGELES, CA
ZIP 90095-001
Phone: (310) 825-0128

The NPI 1821214024 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/17/2007 and was last updated on 6/28/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2100XNurse PractitionerAcute Care16174CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1EX410ZMEDICARE PINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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