Basic Information
| Provider Information | |||||||||
| NPI: | 1750507794 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VAZQUEZ ANAYA | ||||||||
| FirstName: | ANGELICA | ||||||||
| MiddleName: | BETINA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4565 ROCKMART ROAD SE | ||||||||
| Address2: | UNIT 1261 | ||||||||
| City: | SILVER CREEK | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301739998 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7063881176 | ||||||||
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| Practice Location | |||||||||
| Address1: | 428 BILTMORE AVE | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288014502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282134502 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2007 | ||||||||
| LastUpdateDate: | 10/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 2012-01125 | NC | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | 67623 | GA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.