Provider Demographics
NPI:1487954285
Name:MARQUIS, CELIA ANNE MARIE (NP AND RN)
Entity type:Individual
Prefix:MS
First Name:CELIA
Middle Name:ANNE MARIE
Last Name:MARQUIS
Suffix:
Gender:F
Credentials:NP AND RN
Other - Prefix:MS
Other - First Name:CELIA
Other - Middle Name:ANNE MARIE
Other - Last Name:BERGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1305 MORSE BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-3922
Mailing Address - Country:US
Mailing Address - Phone:650-596-6116
Mailing Address - Fax:
Practice Address - Street 1:363 MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1729
Practice Address - Country:US
Practice Address - Phone:650-562-6466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19631363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily