MEDICARE: ANGELICA H MUNGIA

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	390200000X	Student in an Organized Health Care Education/Training Program		CA
2	101Y00000X	Counselor	C262728	CA

General Provider Information

NPI Number	:	1144008210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELICA H MUNGIA

Provider Business Mailing Address
First Line	:	845 E ARROW HWY
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91767-2535
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	845 E ARROW HWY
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91767-2535
Country	:	US
Telephone Number	:	909-624-1233
Fax Number	:

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

Provider Enumeration Date	:	09/19/2023
Last Update Date	:	12/15/2025

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Directions to “ ANGELICA H MUNGIA ” Practice Location

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