Healthcare Provider Details

I. General information

NPI: 1003760448
Provider Name (Legal Business Name): ANGELINA RAY PULIDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6809 INDIANA AVE
RIVERSIDE CA
92506-4221
US

IV. Provider business mailing address

8654 DE LOSS DR
RIVERSIDE CA
92508-2542
US

V. Phone/Fax

Practice location:
  • Phone: 951-774-1338
  • Fax:
Mailing address:
  • Phone: 951-743-3291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: