Provider Demographics
NPI:1710686886
Name:ALLENWASHINGTON, ANGELA NICHOLE (NP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:NICHOLE
Last Name:ALLENWASHINGTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16312 FLALLON AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-7025
Mailing Address - Country:US
Mailing Address - Phone:562-400-5445
Mailing Address - Fax:
Practice Address - Street 1:16312 FLALLON AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-7025
Practice Address - Country:US
Practice Address - Phone:562-657-9506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95018809363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty