Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 14454 | CA |
NPI | 1013983857 |
---|---|
Provider Name | Angela R Acfalle |
First Address | La Jolla, CA 92093-0039 |
Second Address | La Jolla, CA 92093-0039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 20/09/2016 |