Provider Demographics
NPI:1760638571
Name:FIX ORTIZ, ANGELA KATHRYN (DC)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:KATHRYN
Last Name:FIX ORTIZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ANGELA
Other - Middle Name:KATHRYN
Other - Last Name:FIX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:410 S SANTA FE AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-6163
Mailing Address - Country:US
Mailing Address - Phone:760-521-8158
Mailing Address - Fax:
Practice Address - Street 1:410 S SANTA FE AVE
Practice Address - Street 2:STE 201
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-6163
Practice Address - Country:US
Practice Address - Phone:760-521-8158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-30954111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor