Individual
MR. DEWAYNE LEE CECIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AGACNP
Contact information
Practice address
1080 MONROE AVE, SUITE 120, ALBANY, CA 94706
(510) 439-9496
Mailing address
1158 FRANCISCO ST, BERKELEY, CA 94702-1333
(901) 440-7713
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95015622
CA
363LA2100X
Acute Care Nurse Practitioner
95015622
CA
363LC0200X
Critical Care Medicine Nurse Practitioner
95015622
CA
363LF0000X
Family Nurse Practitioner
95015622
CA
Other
Enumeration date
04/10/2020
Last updated
02/03/2025
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