Healthcare Provider Details

I. General information

NPI: 1205497799
Provider Name (Legal Business Name): ANGELICA BOROOMAND LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2019
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S KRAEMER BLVD STE 230
PLACENTIA CA
92870-6110
US

IV. Provider business mailing address

650 N ROSE DR # 503
PLACENTIA CA
92870-7513
US

V. Phone/Fax

Practice location:
  • Phone: 657-315-1226
  • Fax:
Mailing address:
  • Phone: 657-315-1226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number162701
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: