Angelica Pantoja
Registered Nurse, Psych/Mental Health in Provo, UT. Individual provider (NPI-1).
NPI number1902572829
StatusActive
Last updated in NPPESAug 19, 2021
Details
- NPI
- 1902572829
- Entity type
- Individual (NPI-1)
- Name
- Angelica Pantoja
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 19, 2021
- Certification date
- Aug 19, 2021
- Last updated
- Aug 19, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WP0808X | Registered Nurse, Psych/Mental Health | 7177173-3102 | UT | Yes |
Practice location
750 N Freedom BlvdProvo, UT 84601-1677
Phone 801-373-4760 · Fax 801-373-0639
Mailing address
750 N Freedom BlvdProvo, UT 84601-1677
Phone 801-373-4760 · Fax 801-373-0639
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