Healthcare Provider Details

I. General information

NPI: 1467338814
Provider Name (Legal Business Name): CELESTE ACEVES
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 N EUCLID AVE
UPLAND CA
91786-4763
US

IV. Provider business mailing address

1262 W F ST
ONTARIO CA
91762-2549
US

V. Phone/Fax

Practice location:
  • Phone: 909-949-6526
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC19992
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: