Healthcare Provider Details

I. General information

NPI: 1255273454
Provider Name (Legal Business Name): CECELIA BUENO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 BELLEVUE AVE FL 10
LOS ANGELES CA
90026-4017
US

IV. Provider business mailing address

315 W 5TH ST APT 708
LOS ANGELES CA
90013-2530
US

V. Phone/Fax

Practice location:
  • Phone: 213-207-6561
  • Fax: 213-217-9987
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC21428
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT160368
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: