Healthcare Provider Details

I. General information

NPI: 1740184894
Provider Name (Legal Business Name): ANGELIE SOLIS CELIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 CLEMENT ST
SAN FRANCISCO CA
94121-1563
US

IV. Provider business mailing address

440 COMMERCIAL AVE
SOUTH SAN FRANCISCO CA
94080-4637
US

V. Phone/Fax

Practice location:
  • Phone: 415-221-4810
  • Fax:
Mailing address:
  • Phone: 650-922-1382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number836499
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: