Provider Demographics
NPI:1972359636
Name:CERESTI HEALTH INC
Entity type:Organization
Organization Name:CERESTI HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIRK
Authorized Official - Middle Name:
Authorized Official - Last Name:SOENKSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-453-0997
Mailing Address - Street 1:2888 LOKER AVE E STE 110
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010-6683
Mailing Address - Country:US
Mailing Address - Phone:760-492-8957
Mailing Address - Fax:
Practice Address - Street 1:2888 LOKER AVE E STE 110
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92010-6683
Practice Address - Country:US
Practice Address - Phone:760-492-8957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty