Provider Demographics
NPI:1780921627
Name:CEJA, MARINA CASTULA (LMFT 107361)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:CASTULA
Last Name:CEJA
Suffix:
Gender:F
Credentials:LMFT 107361
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 BROADWAY STE 1100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-1527
Mailing Address - Country:US
Mailing Address - Phone:916-874-7711
Mailing Address - Fax:
Practice Address - Street 1:4600 BROADWAY STE 1100
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-1527
Practice Address - Country:US
Practice Address - Phone:916-874-9670
Practice Address - Fax:916-875-6366
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-11
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107361106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist