Provider Demographics
NPI:1275211633
Name:BEJAR FERNANDEZ, CELESTE MARIA
Entity type:Individual
Prefix:
First Name:CELESTE MARIA
Middle Name:
Last Name:BEJAR FERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:971 BONNIE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-6764
Mailing Address - Country:US
Mailing Address - Phone:831-707-7553
Mailing Address - Fax:
Practice Address - Street 1:341 TRES PINOS RD STE 202B
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-5582
Practice Address - Country:US
Practice Address - Phone:831-637-1094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program