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General NPI Number Information
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NPI Number | 1639824287
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Entity Type | Individual
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Provider Name | ANGELICA CHANG FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/12/2022
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Last Update Date | 05/26/2023
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Provider Practice Location Address
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Address Line | 187 E WILBUR RD STE 101
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-7925
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Country | US
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Telephone | 310-558-2925
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Fax |
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Provider Business Mailing Address
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Address Line | 28720 ROADSIDE DR STE 373
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City | AGOURA HILLS
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State | CA
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Zip | 91301-3316
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Country | US
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Telephone | 818-851-9900
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95020007
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License Number State | CA
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