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General NPI Number Information
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NPI Number | 1568676179
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Entity Type | Individual
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Provider Name | CELESTINE MCMAHAN-WONEIS PH.D., M.M.Q.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 264 FARMER ST
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City | FELTON
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State | CA
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Zip | 95018-9416
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Country | US
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Telephone | 831-335-3972
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Fax |
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Provider Business Mailing Address
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Address Line | 264 FARMER ST
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City | FELTON
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State | CA
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Zip | 95018-9416
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Country | US
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Telephone | 831-335-3972
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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