MEDICARE: ANGELINA JASMINE NARCISO

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	103K00000X	Behavior Analyst	1-25-85797	CA

General Provider Information

NPI Number	:	1851116404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELINA JASMINE NARCISO

Provider Business Mailing Address
First Line	:	501 SHATTO PL STE 100
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-1747
Country	:	US
Telephone Number	:	888-428-3223
Fax Number	:	323-866-1881

Provider Business Practice Location Address
First Line	:	2218 KAUSEN DR STE 104
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95758-7178
Country	:	US
Telephone Number	:	888-428-3223
Fax Number	:	323-866-1881

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

Provider Enumeration Date	:	11/19/2024
Last Update Date	:	04/28/2026

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Directions to “ ANGELINA JASMINE NARCISO ” Practice Location

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