Individual provider Active NPI

Marissa Squirrel Celeste

  • Rehabilitation Practitioner
  • Van Nuys, CA
National Provider Identifier
1255530051
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
14303 Sylvan St
Apt. #40
Van Nuys, CA 91401-2605
Phone
(323) 346-0960
Fax
(323) 346-0966
NPI assigned
Jul 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

14303 Sylvan St
Apt. #40
Van Nuys, CA 91401-2605

Mailing address

6055 E Washington Blvd
Suit 900
Commerce, CA 90040-2418
Phone (323) 346-0960

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1255530051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6055 E WASHINGTON BLVD",
            "address_2": "SUIT 900",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900402418",
            "telephone_number": "323-346-0960",
            "fax_number": "323-346-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14303 SYLVAN ST",
            "address_2": "APT. #40",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914012605",
            "telephone_number": "323-346-0960",
            "fax_number": "323-346-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CELESTE",
        "first_name": "MARISSA",
        "middle_name": "SQUIRREL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.