Provider Demographics
NPI:1811565229
Name:WHELAN, CELESTE LISA
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:LISA
Last Name:WHELAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 23RD ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-3303
Mailing Address - Country:US
Mailing Address - Phone:415-650-6424
Mailing Address - Fax:
Practice Address - Street 1:101 GOUGH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-5903
Practice Address - Country:US
Practice Address - Phone:415-240-2831
Practice Address - Fax:415-864-2086
Is Sole Proprietor?:No
Enumeration Date:2021-06-12
Last Update Date:2021-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)