MEDICARE: MRS. CECILE ROSE CO AVILA NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95166025	CA

General Provider Information

NPI Number	:	1336007434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CECILE ROSE CO AVILA NP

Provider Business Mailing Address
First Line	:	18600 COLIMA RD APT N208
Second Line	:
City	:	ROWLAND HEIGHTS
State	:	CA
Zip	:	91748-2877
Country	:	US
Telephone Number	:	213-989-6100
Fax Number	:	626-495-3924

Provider Business Practice Location Address
First Line	:	18600 COLIMA RD APT N208
Second Line	:
City	:	ROWLAND HEIGHTS
State	:	CA
Zip	:	91748-2877
Country	:	US
Telephone Number	:	213-989-6100
Fax Number	:	626-495-3924

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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