Provider Demographics
NPI:1154162238
Name:ECHAORRE, CELESTE
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:
Last Name:ECHAORRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CELESTE
Other - Middle Name:GRACE
Other - Last Name:ECHAORRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:648 ANITA ST
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-5319
Mailing Address - Country:US
Mailing Address - Phone:626-437-9429
Mailing Address - Fax:
Practice Address - Street 1:648 ANITA ST
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-5319
Practice Address - Country:US
Practice Address - Phone:626-437-9429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-04
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33147261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy