Healthcare Provider Details

I. General information

NPI: 1417876194
Provider Name (Legal Business Name): ANGELICA HUERTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13200 CROSSROADS PKWY N STE 335
CITY OF INDUSTRY CA
91746-3485
US

IV. Provider business mailing address

PO BOX 23
MONROVIA CA
91017-0023
US

V. Phone/Fax

Practice location:
  • Phone: 562-821-1491
  • Fax:
Mailing address:
  • Phone: 213-347-4823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW139044
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: