Doctor Name: | MS. ANGELA KRISTINE BUTLER |
NPI Number: | 1013395516 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ABOC |
License Number: | SL5167 |
Business Practice Address: | 644 Plumas St Yuba City, CA - 959914434 |
Business Phone Number: | 5306732828 |
Business Fax Number: | 5306736888 |
Mailing Address: | 644 Plumas St, YUBA CITY |
State: | CA |
Postal Code: | 959914434 |
Phone Number: | 5306732828 |
Fax Number: | 5306736888 |
NPI Enumeration Date: | 05/15/2015 |
NPI Last Update Date: | 05/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | SL5167 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |