Provider Demographics
NPI:1750062147
Name:ARRIETA, ANGELINE MALILAY (FNP)
Entity type:Individual
Prefix:
First Name:ANGELINE
Middle Name:MALILAY
Last Name:ARRIETA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 S 1ST AVE STE A
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-6154
Mailing Address - Country:US
Mailing Address - Phone:626-442-3700
Mailing Address - Fax:
Practice Address - Street 1:611 S 1ST AVE STE A
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-6154
Practice Address - Country:US
Practice Address - Phone:626-442-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2024-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95026298363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily