Provider Demographics
NPI:1700031507
Name:ARENAS, CECILY A (FNP)
Entity Type:Individual
Prefix:
First Name:CECILY
Middle Name:A
Last Name:ARENAS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24061 CYPRESS RD
Mailing Address - Street 2:
Mailing Address - City:WILLITS
Mailing Address - State:CA
Mailing Address - Zip Code:95490-8554
Mailing Address - Country:US
Mailing Address - Phone:707-459-4824
Mailing Address - Fax:
Practice Address - Street 1:24061 CYPRESS RD
Practice Address - Street 2:
Practice Address - City:WILLITS
Practice Address - State:CA
Practice Address - Zip Code:95490-8554
Practice Address - Country:US
Practice Address - Phone:707-459-4824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-20
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF335697363LF0000X
CANP18536363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily