Individual
ANGELLIQUE DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
675 TEXAS ST, FAIRFIELD, CA 94533-6372
(707) 784-8044
Mailing address
2751 NAPA VALLEY CORPORATE DR BLDG B, NAPA, CA 94558-6216
(707) 227-3900
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/01/2017
Last updated
08/11/2023
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