Healthcare Provider Details

I. General information

NPI: 1356251144
Provider Name (Legal Business Name): JASMINE CELAYA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4740 GREEN RIVER RD
CORONA CA
92878-9185
US

IV. Provider business mailing address

5 S A ST
PERRIS CA
92570-2028
US

V. Phone/Fax

Practice location:
  • Phone: 888-515-1793
  • Fax:
Mailing address:
  • Phone: 951-591-5462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: