Provider Demographics
NPI:1619188117
Name:WASHINGTON, ANGEL DEANA (MA,)
Entity Type:Individual
Prefix:MS
First Name:ANGEL
Middle Name:DEANA
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:MA,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1979 GRANDE CIR APT 4
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-4217
Mailing Address - Country:US
Mailing Address - Phone:707-207-3883
Mailing Address - Fax:
Practice Address - Street 1:1979 GRANDE CIR APT 4
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-4217
Practice Address - Country:US
Practice Address - Phone:707-207-3883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA246YC3302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246YC3302XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Physician Office Based