Healthcare Provider Details

I. General information

NPI: 1134866320
Provider Name (Legal Business Name): CELICA GARCIA-PLASCENCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2022
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2553 STATE ST
SAN DIEGO CA
92101-1315
US

IV. Provider business mailing address

2553 STATE ST
SAN DIEGO CA
92101-1315
US

V. Phone/Fax

Practice location:
  • Phone: 858-933-4948
  • Fax:
Mailing address:
  • Phone: 858-933-4948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: