Individual
CELENA THAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7035 N MAPLE AVE STE 102B, FRESNO, CA 93720-8026
(559) 299-2997
Mailing address
1127 N WINTERGREEN AVE, FRESNO, CA 93737-9528
(559) 765-8202
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95017222
CA
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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