Provider Demographics
NPI:1144313735
Name:SPAGNA, ANGELA NORMA (DC)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:NORMA
Last Name:SPAGNA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1633
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93062-1633
Mailing Address - Country:US
Mailing Address - Phone:805-520-0311
Mailing Address - Fax:805-520-0350
Practice Address - Street 1:1445 E LOS ANGELES AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-2817
Practice Address - Country:US
Practice Address - Phone:805-520-0311
Practice Address - Fax:805-520-0350
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18960111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA18960DCMedicare UPIN