Provider Demographics
NPI:1003156829
Name:CELIO, NANCY ANN (MFT)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:ANN
Last Name:CELIO
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 N HARBOR BLVD
Mailing Address - Street 2:202
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1990
Mailing Address - Country:US
Mailing Address - Phone:714-721-3991
Mailing Address - Fax:714-525-0834
Practice Address - Street 1:305 N HARBOR BLVD
Practice Address - Street 2:202
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1990
Practice Address - Country:US
Practice Address - Phone:714-721-3991
Practice Address - Fax:714-525-0834
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC45101106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist