MEDICARE: JESUS CEJA FNP

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	363LF0000X	Family Nurse Practitioner	NP10285	CA

General Provider Information

NPI Number	:	1407834252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESUS CEJA FNP

Provider Business Mailing Address
First Line	:	812 E D ST
Second Line	:
City	:	LEMOORE
State	:	CA
Zip	:	93245-9545
Country	:	US
Telephone Number	:	559-925-1000
Fax Number	:	559-925-1085

Provider Business Practice Location Address
First Line	:	812 E D ST
Second Line	:
City	:	LEMOORE
State	:	CA
Zip	:	93245-9545
Country	:	US
Telephone Number	:	559-925-1000
Fax Number	:	559-925-1085

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

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	09/09/2011

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