Provider Demographics
NPI:1437913696
Name:BIBBS, ANGELA R
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:R
Last Name:BIBBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:956 MATTHEW CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-4170
Mailing Address - Country:US
Mailing Address - Phone:707-759-8201
Mailing Address - Fax:
Practice Address - Street 1:157 S K ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-4011
Practice Address - Country:US
Practice Address - Phone:800-289-5918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion