MEDICARE: CELESTE BASS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula

General Provider Information

NPI Number	:	1992522833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELESTE BASS

Provider Business Mailing Address
First Line	:	2222 TERMINO AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-2515
Country	:	US
Telephone Number	:	619-201-4281
Fax Number	:

Provider Business Practice Location Address
First Line	:	1635 E ANAHEIM ST STE A
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-7120
Country	:	US
Telephone Number	:	619-201-4281
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2024
Last Update Date	:	09/23/2024

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Directions to “ CELESTE BASS ” Practice Location

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