Individual
KEISHA ANGELCOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
222 E MAIN ST STE 117, BARSTOW, CA 92311-2365
(760) 255-1496
Mailing address
209 E GRACE ST APT 1B, BARSTOW, CA 92311-3975
(760) 514-5737
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/23/2024
Last updated
10/23/2024
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