Individual
DR. ANGIE ELLABOUDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, CPNP-PC
Contact information
Practice address
26700 TOWNE CENTRE DR STE 150, FOOTHILL RANCH, CA 92610-2845
(949) 837-7337
Mailing address
318 W WEEPING WILLOW AVE, ORANGE, CA 92865-1089
(714) 679-9890
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95020643
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP95020643
NP LICENSE/FURNISHING NUMBER
CA
Enumeration date
08/13/2022
Last updated
08/13/2022
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