Healthcare Provider Details

I. General information

NPI: 1518489855
Provider Name (Legal Business Name): ANGELICA PAOLA BELTRAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2017
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78060 CALLE ESTADO
LA QUINTA CA
92253-2960
US

IV. Provider business mailing address

51660 AVENIDA VILLA
LA QUINTA CA
92253-3186
US

V. Phone/Fax

Practice location:
  • Phone: 760-364-8229
  • Fax:
Mailing address:
  • Phone: 760-364-8229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number74489
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: