Healthcare Provider Details

I. General information

NPI: 1881170074
Provider Name (Legal Business Name): ISABEL CEJA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2018
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7224 S RECOVERY RD
FRENCH CAMP CA
95231-8901
US

IV. Provider business mailing address

7224 S RECOVERY RD
FRENCH CAMP CA
95231-8901
US

V. Phone/Fax

Practice location:
  • Phone: 916-413-5007
  • Fax:
Mailing address:
  • Phone: 916-413-5007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number735997
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: