Healthcare Provider Details

I. General information

NPI: 1619893203
Provider Name (Legal Business Name): ANGIE MARIAH ORELLANA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 SANFORD AVE
SAN PABLO CA
94806-4885
US

IV. Provider business mailing address

2108 SANFORD AVE
SAN PABLO CA
94806-4885
US

V. Phone/Fax

Practice location:
  • Phone: 510-447-3533
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License NumberW9351015
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: