Provider Demographics
NPI:1265778583
Name:ENCARNACION, ANGELA J (CSA)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:J
Last Name:ENCARNACION
Suffix:
Gender:F
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 S AMPHLETT BLVD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-2707
Mailing Address - Country:US
Mailing Address - Phone:650-539-3700
Mailing Address - Fax:650-227-2270
Practice Address - Street 1:1730 S AMPHLETT BLVD
Practice Address - Street 2:SUITE 111
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-2707
Practice Address - Country:US
Practice Address - Phone:650-539-3700
Practice Address - Fax:650-227-2270
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-13
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care