Provider Demographics
NPI:1346346152
Name:ANGELES, RICA PUNSALANG (ARNP)
Entity Type:Individual
Prefix:MS
First Name:RICA
Middle Name:PUNSALANG
Last Name:ANGELES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1415 OLEANDER AVE
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-5528
Mailing Address - Country:US
Mailing Address - Phone:619-946-4440
Mailing Address - Fax:561-374-5292
Practice Address - Street 1:6390 GREENWICH DR
Practice Address - Street 2:SUITE 185
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-5973
Practice Address - Country:US
Practice Address - Phone:858-277-5200
Practice Address - Fax:561-374-5292
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA327746363LF0000X
FL3206802363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P17798Medicare UPIN
E4812YMedicare ID - Type Unspecified