Healthcare Provider Details

I. General information

NPI: 1124079702
Provider Name (Legal Business Name): CELESTE L ARMENTA RN, MSN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 09/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 ROSS AVE SUITE 101
EL CENTRO CA
92243-3623
US

IV. Provider business mailing address

9610 GRANITE RIDGE DR SUITE B
SAN DIEGO CA
92123-2684
US

V. Phone/Fax

Practice location:
  • Phone: 760-353-0404
  • Fax: 760-353-0392
Mailing address:
  • Phone: 858-810-8000
  • Fax: 858-268-1911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP15871
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: