Healthcare Provider Details

I. General information

NPI: 1649361908
Provider Name (Legal Business Name): ANGELA ELAINE CARREON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA ELAINE GUADAGNI

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 11/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HARTLE CT
NAPA CA
94559-4078
US

IV. Provider business mailing address

1141 PEAR TREE LN STE 100
NAPA CA
94558-6485
US

V. Phone/Fax

Practice location:
  • Phone: 707-254-1775
  • Fax: 707-251-1779
Mailing address:
  • Phone: 707-254-1770
  • Fax: 707-251-1779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP16768
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: