Provider Demographics
NPI:1871284836
Name:LYONS, CELINA OCEAN (LAC, DOM)
Entity type:Individual
Prefix:
First Name:CELINA
Middle Name:OCEAN
Last Name:LYONS
Suffix:
Gender:F
Credentials:LAC, DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 MADISON ST APT 315
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-4532
Mailing Address - Country:US
Mailing Address - Phone:250-896-6332
Mailing Address - Fax:
Practice Address - Street 1:1551 MADISON ST APT 315
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-4532
Practice Address - Country:US
Practice Address - Phone:250-896-6332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10305171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist