Individual
ANGELA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1133 C AMELBACK, NEWPORT BEACH, CA 92658
(949) 520-9884
Mailing address
PO BOX 12771, NEWPORT BEACH, CA 92658-5074
(949) 520-9884
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
26080
CA
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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