Angela M Byndon-Gregory

Individual provider Active NPI Psychiatric/Mental Health Registered Nurse · Ceres, CA

NPI 1063939833 · NPPES record last updated Aug 23, 2017

Key facts

NPI
1063939833
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Registered Nurse 163WP0808X
License
95130537 (CA)
Practice address
1904 Richland Ave
Ceres, CA 95307-4562
Phone
(209) 300-8800
NPI assigned
Aug 23, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
95130537CAMDPsychiatric/Mental Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 95130537 CA Yes

Addresses

Primary practice location

1904 Richland Ave
Ceres, CA 95307-4562

Mailing address

9614 N 11TH St
Tampa, FL 33612-8106
Phone (813) 479-7952

Other providers in Ceres, CA

All providers in Ceres, CA · Psychiatric/Mental Health Registered Nurse in California

Sources for this page

Verify at the official NPI Registry.