Provider Demographics
NPI:1245039791
Name:CENTENO, CELIA
Entity type:Individual
Prefix:
First Name:CELIA
Middle Name:
Last Name:CENTENO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 W PECINA LN
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85194-2000
Mailing Address - Country:US
Mailing Address - Phone:650-313-1301
Mailing Address - Fax:
Practice Address - Street 1:2309 W PECINA LN
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85194-2000
Practice Address - Country:US
Practice Address - Phone:650-313-1301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker