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Individual

CELEDONIA LO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
957 WIND CAVE PL, CHULA VISTA, CA 91914-3613
(856) 723-7296
Mailing address
957 WIND CAVE PL, CHULA VISTA, CA 91914-3613
(856) 723-7296

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
26NO10134700
NJ
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
651097
CA

Other

Enumeration date
05/23/2011
Last updated
05/23/2011
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