Provider Demographics
NPI:1417040825
Name:BAUTISTA, ANGELI ARREGLADO (NP)
Entity Type:Individual
Prefix:MRS
First Name:ANGELI
Middle Name:ARREGLADO
Last Name:BAUTISTA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:ANGELI
Other - Middle Name:ARREGLADO
Other - Last Name:ACIERTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2151 S MONTEREY AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-5426
Mailing Address - Country:US
Mailing Address - Phone:909-986-7929
Mailing Address - Fax:
Practice Address - Street 1:16323 CLARK AVE
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-5209
Practice Address - Country:US
Practice Address - Phone:562-422-3256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16080363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily