Provider Demographics
NPI:1528509171
Name:NAVARRETE, ANGELA M (SA-C)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:M
Last Name:NAVARRETE
Suffix:
Gender:F
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34735 N OPEN RANGE DR
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-4436
Mailing Address - Country:US
Mailing Address - Phone:480-528-6552
Mailing Address - Fax:
Practice Address - Street 1:1586 W MAGGIO WAY APT 2005
Practice Address - Street 2:2005
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224
Practice Address - Country:US
Practice Address - Phone:480-528-6552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16-643246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant