Provider Demographics
NPI:1922972819
Name:ALCAZAR, CECILIA AMADOR
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:AMADOR
Last Name:ALCAZAR
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 1:400 RICKOVER ST
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94592-1128
Mailing Address - Country:US
Mailing Address - Phone:707-556-8620
Mailing Address - Fax:
Practice Address - Street 1:400 RICKOVER ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94592-1128
Practice Address - Country:US
Practice Address - Phone:707-556-8620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADD8A7D5F1B171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach