Provider Demographics
NPI:1396292181
Name:ANGEL, LIZBETH
Entity type:Individual
Prefix:
First Name:LIZBETH
Middle Name:
Last Name:ANGEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LIZBETH
Other - Middle Name:
Other - Last Name:ROMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1401 PARKMOOR AVE
Mailing Address - Street 2:STE. 230
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-3403
Mailing Address - Country:US
Mailing Address - Phone:408-971-9822
Mailing Address - Fax:408-971-9820
Practice Address - Street 1:1401 PARKMOOR AVE
Practice Address - Street 2:STE. 230
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-3403
Practice Address - Country:US
Practice Address - Phone:408-971-9822
Practice Address - Fax:408-971-9820
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-08
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program