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Individual

JAN MATTHEW RAVINA ANGELES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
6815 NOBLE AVE, VAN NUYS, CA 91405-3796
(818) 901-6600
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95025746
CA

Other

Enumeration date
07/17/2023
Last updated
09/02/2025
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