Provider Demographics
NPI:1174358642
Name:POSADAS, SENOBIO CEBALLOS
Entity type:Individual
Prefix:
First Name:SENOBIO
Middle Name:CEBALLOS
Last Name:POSADAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10369 25TH ST
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4711
Mailing Address - Country:US
Mailing Address - Phone:714-398-2777
Mailing Address - Fax:
Practice Address - Street 1:2550 BOULDER DR
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-4480
Practice Address - Country:US
Practice Address - Phone:209-628-3457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB5497245342000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company