Healthcare Provider Details

I. General information

NPI: 1184389322
Provider Name (Legal Business Name): ARETA CEKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2021
Last Update Date: 11/02/2021
Certification Date: 10/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 COCHRAN ST
SIMI VALLEY CA
93065-2263
US

IV. Provider business mailing address

141 S BERENDO ST APT 216
LOS ANGELES CA
90004-5744
US

V. Phone/Fax

Practice location:
  • Phone: 805-522-8063
  • Fax:
Mailing address:
  • Phone: 646-894-5349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number84760
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: