Provider Demographics
NPI:1386855518
Name:DALE, ANGELA KAYE (RN CLC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:KAYE
Last Name:DALE
Suffix:
Gender:F
Credentials:RN CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42096 PASEO RAYO DEL SOL
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-1937
Mailing Address - Country:US
Mailing Address - Phone:951-676-1731
Mailing Address - Fax:
Practice Address - Street 1:42096 PASEO RAYO DEL SOL
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-1937
Practice Address - Country:US
Practice Address - Phone:951-676-1731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA515475163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant