Provider Demographics
NPI:1568426112
Name:SAMORA, CELESTINA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:CELESTINA
Middle Name:
Last Name:SAMORA
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:MRS
Other - First Name:TINA
Other - Middle Name:
Other - Last Name:SAMORA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:800 DELBON AVE
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-2005
Mailing Address - Country:US
Mailing Address - Phone:209-664-8005
Mailing Address - Fax:209-664-8530
Practice Address - Street 1:800 DELBON AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2005
Practice Address - Country:US
Practice Address - Phone:209-664-8005
Practice Address - Fax:209-664-8530
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA283193363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology