Individual
ANGELIQUE N DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6501 VAN NUYS BLVD STE 103, VAN NUYS, CA 91401-1425
(818) 902-5315
Mailing address
6501 VAN NUYS BLVD STE 103, VAN NUYS, CA 91401-1425
(818) 902-5315
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
A9620386
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2254000000X
CASE MANAGER 1
CA
Enumeration date
12/02/2022
Last updated
12/02/2022
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