Healthcare Provider Details

I. General information

NPI: 1770487969
Provider Name (Legal Business Name): ANGELICA DATU NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18906 CARRANZA LN
SANTA CLARITA CA
91350-2191
US

IV. Provider business mailing address

18906 CARRANZA LN
SANTA CLARITA CA
91350-2191
US

V. Phone/Fax

Practice location:
  • Phone: 818-730-2215
  • Fax:
Mailing address:
  • Phone: 818-730-2215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95041791
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: