Individual
MRS. MARILYN KAY MANGELOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
838 COBBLESTONE CT, RIPON, CA 95366-2656
(209) 599-4917
(209) 599-9275
Mailing address
838 COBBLESTONE CT, RIPON, CA 95366-2656
(209) 599-4917
(209) 599-9275
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN258880
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EPS005060
MEDICAL PROVIDER NUMBER
CA
Enumeration date
03/27/2007
Last updated
07/08/2007
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