Mayra Celis, SLPA

Individual provider Active NPI Speech-Language Assistant · Riverside, CA

NPI 1417394685 · NPPES record last updated May 29, 2013

Key facts

NPI
1417394685
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Assistant 2355S0801X
License
2112 (CA)
Practice address
6180 Brockton Ave Ste 102
Riverside, CA 92506-2259
Phone
(951) 684-6500
NPI assigned
May 29, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2112CAMDSpeech-Language Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 2112 CA Yes

Addresses

Primary practice location

6180 Brockton Ave Ste 102
Riverside, CA 92506-2259

Mailing address

15581 Nadia St
Moreno Valley, CA 92551-6918

Other providers in Riverside, CA

All providers in Riverside, CA · Speech-Language Assistant in California

Sources for this page

Verify at the official NPI Registry.