Angela Rose Gibby, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

125505 Issued in CA

Practice address

6500 Morro Rd Ste C&D
Atascadero, CA 93422-4142

Phone

(805) 461-5212

NPI assigned

Jan 12, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Aegis Treatment Centers, LLC

  • Methadone Clinic
  • Canoga Park, CA
  • NPI 1831601764
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1578787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578787200000",
    "number": "1902446560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 MORRO RD STE C&D",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934224142",
            "telephone_number": "805-461-5212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 MORRO RD STE C&D",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934224142",
            "telephone_number": "805-461-5212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBY",
        "first_name": "ANGELA",
        "middle_name": "ROSE",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-12",
        "last_updated": "2020-01-12",
        "certification_date": "2020-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "125505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roy Paul Germano Jr., M.D.
• Bruce Gerstenkorn, OTR/L
• Shirin Ghannadi, PSY.D.
• Haris Ghayur, MD
• Neil Giannini, MA, LMFT
• Gary Alan Gibson, R.A.S.I.
• Beth Francine Gier, PHD
• Wendy Holaday Giggy, MFCC
• Patricia Gillig
• Skyler Gin

• Licensed Vocational Nurse in Atascadero, CA
• Providers in Atascadero, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.