Provider Demographics
NPI:1376981159
Name:CARAZA, ANGELA MARIE (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:MARIE
Last Name:CARAZA
Suffix:
Gender:F
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 BRISTOL ST STE J102
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-7918
Mailing Address - Country:US
Mailing Address - Phone:949-392-6490
Mailing Address - Fax:949-392-6491
Practice Address - Street 1:2900 BRISTOL ST STE J102
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-7918
Practice Address - Country:US
Practice Address - Phone:949-392-6490
Practice Address - Fax:949-392-6491
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32374111N00000X
CA15371171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist