Healthcare Provider Details

I. General information

NPI: 1609192871
Provider Name (Legal Business Name): ANGEL ALCALA HURTADO MSW, ACSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2010
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4420 60TH ST
SACRAMENTO CA
95820-4208
US

IV. Provider business mailing address

4420 60TH ST
SACRAMENTO CA
95820-4208
US

V. Phone/Fax

Practice location:
  • Phone: 916-479-0351
  • Fax:
Mailing address:
  • Phone: 916-479-0351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number27847
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: