Healthcare Provider Details

I. General information

NPI: 1003218504
Provider Name (Legal Business Name): ANGELINA ORDUNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2014
Last Update Date: 09/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 ALHAMBRA AVE
MARTINEZ CA
94553-2300
US

IV. Provider business mailing address

5674 STONERIDGE DR 207
PLEASANTON CA
94588-8500
US

V. Phone/Fax

Practice location:
  • Phone: 925-228-4200
  • Fax:
Mailing address:
  • Phone: 925-520-0005
  • Fax: 925-520-0010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: