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NPI Code Detail

MEDICARE: DR. MARY S CELAYA DNP FNP PMHNP

MEDICARE: DR. MARY S CELAYA DNP FNP PMHNP
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
1363LF0000XFamily Nurse PractitionerNP 11425CA

General Provider Information

NPI Number : 1710060231
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY S CELAYA DNP FNP PMHNP
Provider Business Mailing Address
First Line : 425 N DATE ST
Second Line :
City : ESCONDIDO
State : CA
Zip : 92025-3413
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 41840 ENTERPRISE CIR N
Second Line :
City : TEMECULA
State : CA
Zip : 92590-5654
Country : US
Telephone Number : 951-225-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2006
Last Update Date : 02/23/2016

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