PENNY ANGEL MATA MEDICAL ASSISTANT
NPI 1518601020
Specialist/Technologist in Caldwell, ID

Q: What is the provider's specialty?

The provider's specialty is Specialist/Technologist with taxonomy code 235500000X.

Active since April 21, 2022

4521 THOMAS JEFFERSON ST, CALDWELL, ID 83605(208) 454-4820(208) 454-4859 Get Directions Write a Review

NPPES record last updated: April 21, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Penny Angel Mata Medical Assistant NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PENNY ANGEL MATA MEDICAL ASSISTANT (NPI 1518601020) is an individual specialist/technologist in Caldwell, Idaho and active in the NPI registry since April 2022.

NPPES Registry Identity

NPI1518601020

Entity TypeIndividualFemale

Primary Taxonomy235500000X

Provider Legal NamePENNY ANGEL MATACredential: MEDICAL ASSISTANT

Location Address4521 THOMAS JEFFERSON STCaldwell, ID 83605-5100

Mailing Address4521 Thomas Jefferson StCaldwell, ID 83605-5100 · (208) 454-4820 · Fax (208) 454-4859

Phone(208) 454-4820

Fax(208) 454-4859

Sole ProprietorNo

Enumeration DateApril 21, 2022

NPPES CertifiedApril 21, 2022

✔ NPI 1518601020 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/TechnologistSpeech, Language and Hearing Service Providers

Taxonomy Code235500000X

Definition

General classification identifying speech, language and hearing services individuals who are trained on a specific piece of equipment or technical procedure.

4521 THOMAS JEFFERSON ST, Caldwell, ID 83605

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