Cecelia Forsythe

Individual provider Active NPI Specialist · Alta, CA

NPI 1083733489 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1083733489
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
Practice address
34248 E. Towle Rd.
Alta, CA 95701
Phone
(530) 389-9208
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Yes

Addresses

Primary practice location

34248 E. Towle Rd.
Alta, CA 95701

Mailing address

PO Box 1150
Alta, CA 95701-1150

Other identifiers

IdentifierTypeStateIssuer
5504OtherCACAS REGISTRATION

Other providers in Alta, CA

All providers in Alta, CA · Specialist in California

Sources for this page

Verify at the official NPI Registry.