Provider Demographics
NPI:1629240775
Name:CEA, XIOMARA ISABEL (MFT-I)
Entity Type:Individual
Prefix:MRS
First Name:XIOMARA
Middle Name:ISABEL
Last Name:CEA
Suffix:
Gender:F
Credentials:MFT-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 POINSETTIA ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-2917
Mailing Address - Country:US
Mailing Address - Phone:714-541-6627
Mailing Address - Fax:
Practice Address - Street 1:1825 POINSETTIA ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-2917
Practice Address - Country:US
Practice Address - Phone:714-541-6627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51322101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health