Healthcare Provider Details

I. General information

NPI: 1144810516
Provider Name (Legal Business Name): ANGELA LEDESMA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2021
Last Update Date: 01/20/2021
Certification Date: 01/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 CONSTITUTION BLVD
SALINAS CA
93906-3100
US

IV. Provider business mailing address

3132 LYNSCOTT DR
MARINA CA
93933-3413
US

V. Phone/Fax

Practice location:
  • Phone: 831-769-8682
  • Fax: 831-796-1600
Mailing address:
  • Phone: 831-601-0908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number525967
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number525961
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: