Individual
ANGELIQUE GRACE PUTRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
31700 TEMECULA PKWY STE 2, TEMECULA, CA 92592-5896
(951) 600-4337
Mailing address
31700 TEMECULA PKWY STE 2, TEMECULA, CA 92592-5896
(951) 600-4337
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
93889864H
—
CA
05
—
A23630640
—
AZ
Enumeration date
10/31/2025
Last updated
04/25/2026
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