Provider Demographics
NPI:1538870126
Name:CEJA, BEATRIZ ANNETTE
Entity type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:ANNETTE
Last Name:CEJA
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 1:1612 WOODSTONE CT
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-8339
Mailing Address - Country:US
Mailing Address - Phone:956-740-1214
Mailing Address - Fax:
Practice Address - Street 1:1612 WOODSTONE CT
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-8339
Practice Address - Country:US
Practice Address - Phone:956-740-1214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX632001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty