Healthcare Provider Details

I. General information

NPI: 1174478226
Provider Name (Legal Business Name): COACHELLA VALLEY ANGELS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43875 WASHINGTON ST STE H
PALM DESERT CA
92211-8249
US

IV. Provider business mailing address

43875 WASHINGTON ST STE H
PALM DESERT CA
92211-8249
US

V. Phone/Fax

Practice location:
  • Phone: 760-404-0220
  • Fax:
Mailing address:
  • Phone: 760-404-0220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: SARA BRIDGEWATER
Title or Position: PRESIDENT
Credential:
Phone: 859-202-1049