Basic Information
| Provider Information | |||||||||
| NPI: | 1831843564 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LLAMAS | ||||||||
| FirstName: | ANGELICA | ||||||||
| MiddleName: | |||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 115 MALL DR | ||||||||
| Address2: | |||||||||
| City: | HANFORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932305786 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6616332300 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 115 MALL DR | ||||||||
| Address2: | |||||||||
| City: | HANFORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932305786 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6616332300 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2022 | ||||||||
| LastUpdateDate: | 03/30/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 846844 | CA | N | Nursing Service Providers | Registered Nurse | 163WR0006X | 95001722 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Nursing Service Providers | Registered Nurse | Registered Nurse First Assistant |
No ID Information.