Healthcare Provider Details

I. General information

NPI: 1124841655
Provider Name (Legal Business Name): CECILIA ALMAZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

771 W BLAINE ST STE C&D
RIVERSIDE CA
92507-3940
US

IV. Provider business mailing address

771 W BLAINE ST STE C&D
RIVERSIDE CA
92507-3940
US

V. Phone/Fax

Practice location:
  • Phone: 951-955-2233
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-XRMYVE
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: