Individual
ANGELICA GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5005 TEXAS ST, SAN DIEGO, CA 92108
(619) 692-0727
Mailing address
5005 TEXAS ST STE 203, SAN DIEGO, CA 92108-3723
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/28/2019
Last updated
01/28/2019
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