Provider Demographics
NPI:1568861748
Name:TOLENTINO, ANGELICA JANABAJAL
Entity Type:Individual
Prefix:MS
First Name:ANGELICA
Middle Name:JANABAJAL
Last Name:TOLENTINO
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 1:7154 AQUAMARINE RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92114-7902
Mailing Address - Country:US
Mailing Address - Phone:917-378-4969
Mailing Address - Fax:
Practice Address - Street 1:5296 UNIVERSITY AVE STE F2
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-2269
Practice Address - Country:US
Practice Address - Phone:619-578-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator