Healthcare Provider Details

I. General information

NPI: 1881427425
Provider Name (Legal Business Name): ANGELA HOVER PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2542 S BASCOM AVE STE 110
CAMPBELL CA
95008-5541
US

IV. Provider business mailing address

2542 S BASCOM AVE STE 110
CAMPBELL CA
95008-5541
US

V. Phone/Fax

Practice location:
  • Phone: 408-559-3403
  • Fax:
Mailing address:
  • Phone: 408-559-3403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95030667
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: