Provider Demographics
NPI:1629410675
Name:RYAN, CELESTE HOWE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CELESTE
Middle Name:HOWE
Last Name:RYAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CELESTE
Other - Middle Name:LYNN
Other - Last Name:HOWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3871 HEPBURN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-1922
Mailing Address - Country:US
Mailing Address - Phone:310-384-3600
Mailing Address - Fax:
Practice Address - Street 1:3871 HEPBURN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-1922
Practice Address - Country:US
Practice Address - Phone:310-384-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-18
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 21417103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist