Provider Demographics
NPI:1407445117
Name:WAYMENT, CELINA RANAE
Entity Type:Individual
Prefix:
First Name:CELINA
Middle Name:RANAE
Last Name:WAYMENT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 E. COLORADO BLVD. SUITE 560
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106
Mailing Address - Country:US
Mailing Address - Phone:818-241-6780
Mailing Address - Fax:818-241-6853
Practice Address - Street 1:662 ENCINITAS BLVD STE 208
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-6789
Practice Address - Country:US
Practice Address - Phone:760-634-1125
Practice Address - Fax:760-634-1530
Is Sole Proprietor?:No
Enumeration Date:2021-01-16
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician