Healthcare Provider Details

I. General information

NPI: 1922713320
Provider Name (Legal Business Name): HANNELORE RANGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2023
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2496 1/2 ISLAND AVE
SAN DIEGO CA
92102-2923
US

IV. Provider business mailing address

3111 CAMINO DEL RIO N STE 400
SAN DIEGO CA
92108-5724
US

V. Phone/Fax

Practice location:
  • Phone: 619-510-1661
  • Fax:
Mailing address:
  • Phone: 888-922-2843
  • Fax: 855-568-2494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: