Provider Demographics
NPI:1043760671
Name:CELIS, EMILY (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:CELIS
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14081 YORBA ST STE 105
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-2050
Mailing Address - Country:US
Mailing Address - Phone:714-391-3853
Mailing Address - Fax:888-338-1074
Practice Address - Street 1:14081 YORBA ST STE 105
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2050
Practice Address - Country:US
Practice Address - Phone:714-391-3853
Practice Address - Fax:888-338-1074
Is Sole Proprietor?:No
Enumeration Date:2016-10-06
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82604106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist