Individual
ANGELLA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2931 REDONDO AVE, LONG BEACH, CA 90806-2445
(562) 490-7600
(562) 490-7601
Mailing address
11306 PAYTON, IRVINE, CA 92620-3503
(714) 360-9758
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
ASW21115
CA
Other
Enumeration date
11/20/2008
Last updated
11/20/2008
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