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Individual

ANGELICA MARIE CEJA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1036 PUEBLO AVE TRLR 9, NAPA, CA 94558-3543
(707) 392-8677
Mailing address
1036 PUEBLO AVE TRLR 9, NAPA, CA 94558-3543
(707) 392-8677

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
7517178457
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
96657454A88095
CA
Enumeration date
06/13/2018
Last updated
06/13/2018
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