Individual
ANGELICA LYNETTE TELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
920 16TH ST # AT, MODESTO, CA 95354-1119
(209) 281-3644
Mailing address
920 16TH ST, MODESTO, CA 95354-1119
(209) 525-6155
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-ZWYVKF
CA
Other
Enumeration date
01/14/2025
Last updated
04/30/2025
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