Provider Demographics
NPI:1427451970
Name:CHICO, CELINA FLORES (MS, LAC)
Entity type:Individual
Prefix:
First Name:CELINA
Middle Name:FLORES
Last Name:CHICO
Suffix:
Gender:F
Credentials:MS, LAC
Other - Prefix:
Other - First Name:PAOLO
Other - Middle Name:FLORES
Other - Last Name:CHICO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4454A PIEDMONT AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-4219
Mailing Address - Country:US
Mailing Address - Phone:510-409-9429
Mailing Address - Fax:
Practice Address - Street 1:4454A PIEDMONT AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-4219
Practice Address - Country:US
Practice Address - Phone:510-409-9429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16012171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist