Provider Demographics
NPI:1780383596
Name:CEJA, ALBERTO DAMIAN
Entity type:Individual
Prefix:
First Name:ALBERTO
Middle Name:DAMIAN
Last Name:CEJA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:943 MEADOWLARK DR
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:CA
Mailing Address - Zip Code:93015-1139
Mailing Address - Country:US
Mailing Address - Phone:805-775-7131
Mailing Address - Fax:
Practice Address - Street 1:21241 VENTURA BLVD STE 187
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2196
Practice Address - Country:US
Practice Address - Phone:818-203-5063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician