=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235641986
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GERRALD CALINGASAN ANGELES NP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/02/2017
-----------------------------------------------------
Last Update Date | 08/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5050 PALO VERDE ST STE 103I
-----------------------------------------------------
City | MONTCLAIR
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91763-2333
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-262-4778
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5050 PALO VERDE ST STE 103I
-----------------------------------------------------
City | MONTCLAIR
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91763-2333
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 95007566
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 95007566
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------