Provider Demographics
NPI:1891982567
Name:ANGEL, MANUELA ESCANDIA
Entity Type:Individual
Prefix:
First Name:MANUELA
Middle Name:ESCANDIA
Last Name:ANGEL
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 1:265 E MCFARLANE ST
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-1558
Mailing Address - Country:US
Mailing Address - Phone:818-398-2244
Mailing Address - Fax:
Practice Address - Street 1:265 E MCFARLANE ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-1558
Practice Address - Country:US
Practice Address - Phone:818-398-2244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator