Individual
ANGIE-KOLLEEN SANDICO TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9606 CHERRY HILL ST, PACOIMA, CA 91331-1514
(323) 620-7412
Mailing address
9606 CHERRY HILL ST, PACOIMA, CA 91331-1514
(323) 620-7412
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
775609
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP95006893
CA
Other
Enumeration date
09/28/2016
Last updated
10/17/2017
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