Provider Demographics
NPI:1699054049
Name:GALATIERRA-GANDING, ANGELA (LAC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:GALATIERRA-GANDING
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:FAYE
Other - Last Name:GALATIERRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:L AC
Mailing Address - Street 1:330 VAN BUREN AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-4393
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:214 DE ANZA BLVD
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-3913
Practice Address - Country:US
Practice Address - Phone:707-228-2772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14371171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist