| Doctor Name: | CELESTE CLARK |
| NPI Number: | 1285866939 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | RN146571 |
| Business Practice Address: | 5342 Dudley Blvd # 98 Mcclellan, CA - 956521012 |
| Business Phone Number: | 9165617520 |
| Business Fax Number: | |
| Mailing Address: | 5200 Brondsbury Ln, FAIR OAKS |
| State: | CA |
| Postal Code: | 956284087 |
| Phone Number: | 9165617520 |
| Fax Number: | |
| NPI Enumeration Date: | 08/13/2009 |
| NPI Last Update Date: | 08/13/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC0400X |
| License Number: | RN146571 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Case Management |
| Taxonomy Definition: | |