Individual
ANGELICA SANTOS TALAVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
115 JETER ST, SANTA CRUZ, CA 95060-5816
(510) 650-7623
Mailing address
115 JETER ST, SANTA CRUZ, CA 95060-5816
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
CA
Enumeration date
10/24/2022
Last updated
10/24/2022
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