Provider Demographics
NPI:1821341777
Name:NWOCHIE, ANGEL O (NP)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:O
Last Name:NWOCHIE
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 1:19422 RADLETT AVE
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-2686
Mailing Address - Country:US
Mailing Address - Phone:310-537-8867
Mailing Address - Fax:
Practice Address - Street 1:201 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-1425
Practice Address - Country:US
Practice Address - Phone:310-635-7123
Practice Address - Fax:310-635-0535
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21899363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner