Healthcare Provider Details

I. General information

NPI: 1871419580
Provider Name (Legal Business Name): ANGELES KARINA RAYON
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: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2549 N STROKESBERRY PL
MERIDIAN ID
83646
US

IV. Provider business mailing address

203 LONE STAR RD
NAMPA ID
83651-2503
US

V. Phone/Fax

Practice location:
  • Phone: 478-449-5275
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: