Individual
AMBER J CENICEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1025 STRAKA TER, OKLAHOMA CITY, OK 73139-2544
(405) 632-6688
(405) 604-0708
Mailing address
1025 STRAKA TER, OKLAHOMA CITY, OK 73139-2544
(405) 632-6688
(405) 604-0708
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1501
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200076670A
—
OK
05
—
243608102
—
OK
Enumeration date
07/04/2006
Last updated
07/23/2008
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