Individual
ANGELINE CAMILLE EUGENIO BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25538 CHISOM LN, STEVENSON RANCH, CA 91381-1637
(661) 877-6089
Mailing address
25538 CHISOM LN, STEVENSON RANCH, CA 91381-1637
(661) 877-6089
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
INT43041
CA
Other
Enumeration date
08/05/2022
Last updated
08/05/2022
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