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General NPI Number Information
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NPI Number | 1639637945
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Entity Type | Individual
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Provider Name | JUNEFAITH CANGREJO ISMAGIL FNP
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Gender | Female
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Dates
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Enumeration Date | 03/05/2019
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Last Update Date | 03/05/2019
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Provider Practice Location Address
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Address Line | 3356 W BALL RD STE 100
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City | ANAHEIM
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State | CA
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Zip | 92804-3727
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Country | US
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Telephone | 714-827-6625
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Fax | 714-827-9726
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Provider Business Mailing Address
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Address Line | 9262 CAPE COD DR
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-3502
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Country | US
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Telephone | 714-362-4344
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | NP95009494
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License Number State | CA
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