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Mariela Celeste Ventocilla
Adult Medicine Physician in Twentynine Palms, California
NPI 1972846756

Mariela Celeste Ventocilla is an Adult Medicine Physician based in Twentynine Palms, CA and is specialized in Adult Medicine. Mariela Celeste Ventocilla practices in Twentynine Palms, CA. The NPI Number for Mariela Celeste Ventocilla is 1972846756 and holds a License No. (California).

The current practice location address for Mariela Celeste Ventocilla is 1145 Sturgis Road, Twentynine Palms, CA and can be reached out via phone at 916-734-2356.

Location: 1145 Sturgis Road, Twentynine Palms, CA, 92277-9482
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1972846756
Provider Name
Mariela Celeste Ventocilla
Credential
Provider Entity Type
Individual
Gender
Female
Address
1145 Sturgis Road, Twentynine Palms, CA, 92277-9482
Phone Number
916-734-2356
Fax Number
Provider Enumeration Date
03/31/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
010127041 01 VA LISCENCE NUMBER
institution
Provider Business Practice Location Address Details
Address
1145 Sturgis Road
City
Twentynine Palms
State
California
Zip
92277
Phone Number
916-734-2356
Fax Number
person
Provider Business Mailing Address Details
Address
1145 Sturgis Road
City
Twentynine Palms
State
California
Zip
92277
Phone Number
916-734-2356
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
010127041 (Virginia)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
Adult Medicine
Taxonomy
207QA0505X
License No.
()
Definition
Definition to come.
person
Provider's Taxonomy Details 3
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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