PENNY ANGEL MATA MEDICAL ASSISTANT NPI 1518601020

NPI Information

NPI: 1518601020
Provider Name: PENNY ANGEL MATA, MEDICAL ASSISTANT
Classification: Specialist/Technologist - 235500000X
Entity Type: Individual
Address:
4521 THOMAS JEFFERSON ST
CALDWELL, ID
ZIP 83605
Phone: (208) 454-4820
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Penny Angel Mata, MEDICAL ASSISTANT is a specialist technologist in Caldwell, ID. The provider is general classification identifying speech, language and hearing services individuals who are trained on a specific piece of equipment or technical procedure. Penny Angel Mata, MEDICAL ASSISTANT NPI is 1518601020. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4521 THOMAS JEFFERSON ST
CALDWELL, ID
ZIP 83605-100
Phone: (208) 454-4820
Fax: (208) 454-4859

The enumeration date for this NPI number is 4/21/2022 and was last updated on 4/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	235500000X	Specialist/Technologist				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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