Provider Demographics
NPI:1609521657
Name:CELESTINE, RONALD EDWARD (ND, PHD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:EDWARD
Last Name:CELESTINE
Suffix:
Gender:M
Credentials:ND, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2587 VAQUERO VISTA DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-9088
Mailing Address - Country:US
Mailing Address - Phone:360-463-4296
Mailing Address - Fax:
Practice Address - Street 1:151 N SUNRISE AVE STE 1411
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2934
Practice Address - Country:US
Practice Address - Phone:279-888-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA804175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath