MEDICARE: MS. ANGELA JOSEPH MSN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC2100X	Continence Care Registered Nurse	189407	CA
2	163WR0400X	Rehabilitation Registered Nurse	189407	CA
3	163WU0100X	Urology Registered Nurse	189407	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	189407	OTHER	CA	RN LICENSE
2	468	OTHER	CA	CNS CERTIFICATE

General Provider Information

NPI Number	:	1023129046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANGELA JOSEPH MSN

Provider Business Mailing Address
First Line	:	4280 CAMINITO PINTORESCO
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-4230
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3350 LA JOLLA VILLAGE DR
Second Line	:
City	:	LA JOLLA
State	:	CA
Zip	:	92037-1806
Country	:	US
Telephone Number	:	858-642-3113
Fax Number	:	858-552-4315

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	06/14/2026

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