Healthcare Provider Details

I. General information

NPI: 1770691644
Provider Name (Legal Business Name): ANGELA E WALDROP PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 MARKET ST STE 341
SAN FRANCISCO CA
94102-3022
US

IV. Provider business mailing address

870 MARKET ST STE 341
SAN FRANCISCO CA
94102-3022
US

V. Phone/Fax

Practice location:
  • Phone: 415-638-3568
  • Fax:
Mailing address:
  • Phone: 415-638-3568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberTPPY3039
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number202400
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY23535
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY23535
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number23535
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number38862
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: