Healthcare Provider Details

I. General information

NPI: 1659403616
Provider Name (Legal Business Name): CELINE C FUA N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 KOLL CENTER PKWY STE 140
PLEASANTON CA
94566-7077
US

IV. Provider business mailing address

1206 SILVERTON WAY
BRENTWOOD CA
94513-6806
US

V. Phone/Fax

Practice location:
  • Phone: 925-829-8770
  • Fax:
Mailing address:
  • Phone: 609-647-5073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP20703
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: