Provider Demographics
NPI:1568200947
Name:BAEZ, ANGELINA (CNS-CANDIDATE, MS)
Entity type:Individual
Prefix:
First Name:ANGELINA
Middle Name:
Last Name:BAEZ
Suffix:
Gender:F
Credentials:CNS-CANDIDATE, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16689 SWIFT FOX AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-7999
Mailing Address - Country:US
Mailing Address - Phone:909-703-1496
Mailing Address - Fax:
Practice Address - Street 1:16689 SWIFT FOX AVE
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-7999
Practice Address - Country:US
Practice Address - Phone:909-703-1496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist