Individual provider · NPI-1

Katherine Rae Angeles, NP

Nurse Practitioner, Pediatrics · Loma Linda, CA

NPI number1780215699
StatusActive
Last updated in NPPESNov 5, 2020

Details

NPI
1780215699
Entity type
Individual (NPI-1)
Name
Ms. Katherine Rae Angeles
Credential
NP
Sex
Female
Sole proprietor
No
Enumeration date
Jan 29, 2020
Certification date
Nov 5, 2020
Last updated
Nov 5, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, Pediatrics95015701CAYes
163WP0200X Registered Nurse, Pediatrics818775CA

Other names

  • Katie Angeles (Other Name)

Practice location

1720 Mountain View Ave
Loma Linda, CA 92354-1727

Phone 909-796-6915

Mailing address

11524 Chapman Ave
Loma Linda, CA 92354-3954

Phone 909-725-4288

Other practice locations

11524 Chapman Ave
Loma Linda, CA 92354-3954

Phone 909-725-4288

26520 Cactus Ave
Moreno Valley, CA 92555-3927

Phone 951-486-5450

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