MEDICARE: MRS. AMY RANGEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	14219	CA

General Provider Information

NPI Number	:	1528991742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMY RANGEL

Provider Business Mailing Address
First Line	:	83 ENDLESS VIS
Second Line	:
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-8057
Country	:	US
Telephone Number	:	949-705-8775
Fax Number	:

Provider Business Practice Location Address
First Line	:	83 ENDLESS VIS
Second Line	:
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-8057
Country	:	US
Telephone Number	:	949-705-8775
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2026
Last Update Date	:	06/06/2026

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