Healthcare Provider Details

I. General information

NPI: 1447154620
Provider Name (Legal Business Name): CELIA VASQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27570 COLLIER DR
MENIFEE CA
92585-8112
US

IV. Provider business mailing address

3524 CHERRY BLOSSOM LN
LAKE ELSINORE CA
92530-1846
US

V. Phone/Fax

Practice location:
  • Phone: 424-832-0644
  • Fax:
Mailing address:
  • Phone: 562-316-8798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: