Healthcare Provider Details

I. General information

NPI: 1558720250
Provider Name (Legal Business Name): ANETA RYGIEL ACWS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2016
Last Update Date: 10/27/2020
Certification Date: 10/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 HOSPITAL ROAD
SONORA CA
95370-5227
US

IV. Provider business mailing address

2. S GREEN STREET
SONORA CA
95370-4618
US

V. Phone/Fax

Practice location:
  • Phone: 209-533-6245
  • Fax:
Mailing address:
  • Phone: 209-533-6245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number72930
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number72930
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberACSW72930
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: