Healthcare Provider Details

I. General information

NPI: 1962324152
Provider Name (Legal Business Name): ANGELICA PRISCILLA AVALOS ACOSTA PUPIL PERSONNEL SERV
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42111 ROAD 128
OROSI CA
93647-9749
US

IV. Provider business mailing address

12623 AVENUE 416
OROSI CA
93647-2017
US

V. Phone/Fax

Practice location:
  • Phone: 559-528-3702
  • Fax:
Mailing address:
  • Phone: 559-528-4763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: