Healthcare Provider Details

I. General information

NPI: 1801649363
Provider Name (Legal Business Name): ALECIA DEANGELIS PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2024
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 QUAIL ST STE 252
NEWPORT BEACH CA
92660-2714
US

IV. Provider business mailing address

1400 QUAIL ST STE 252
NEWPORT BEACH CA
92660-2714
US

V. Phone/Fax

Practice location:
  • Phone: 949-328-5693
  • Fax:
Mailing address:
  • Phone: 602-802-4344
  • Fax: 949-276-3212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP95029651
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: