Healthcare Provider Details

I. General information

NPI: 1780599456
Provider Name (Legal Business Name): MICHELLE ITZEL RANGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1691 GRAMERCY AVE
TORRANCE CA
90501-3236
US

IV. Provider business mailing address

5113 W 142ND ST
HAWTHORNE CA
90250-6607
US

V. Phone/Fax

Practice location:
  • Phone: 310-220-9076
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: