Healthcare Provider Details

I. General information

NPI: 1356296057
Provider Name (Legal Business Name): ANGELA P REEDY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 02/27/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20331 FLANAGAN RD
TRABUCO CANYON CA
92679
US

IV. Provider business mailing address

17171 BOLSA CHICA ST APT 67
HUNTINGTON BEACH CA
92649-5129
US

V. Phone/Fax

Practice location:
  • Phone: 818-582-8832
  • Fax:
Mailing address:
  • Phone: 714-567-1088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberRT1432010226
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: