Provider Demographics
NPI:1265247449
Name:FLORES, ANGELA TEJEDA (CPT1)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:TEJEDA
Last Name:FLORES
Suffix:
Gender:F
Credentials:CPT1
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:LYNN
Other - Last Name:TEJEDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPT1
Mailing Address - Street 1:15233 VENTURA BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2231
Mailing Address - Country:US
Mailing Address - Phone:747-343-1608
Mailing Address - Fax:
Practice Address - Street 1:15233 VENTURA BLVD STE 500
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2231
Practice Address - Country:US
Practice Address - Phone:747-343-1608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPT-00031139246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy