Provider Demographics
NPI:1154766616
Name:CHAVEZ, CELESTE DENISE (FNP)
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:DENISE
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CELESTE
Other - Middle Name:DENISE
Other - Last Name:BOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:650-853-2865
Mailing Address - Fax:
Practice Address - Street 1:87 ENCINA AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2322
Practice Address - Country:US
Practice Address - Phone:650-853-2975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA371234363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner