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General NPI Number Information
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NPI Number | 1013048644
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Entity Type | Individual
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Provider Name | DR. KANGHO ANG
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Gender | Male
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 7707 AUSTIN RD
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City | STOCKTON
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State | CA
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Zip | 95215-8312
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Country | US
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Telephone | 209-467-8546
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Fax |
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Provider Business Mailing Address
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Address Line | 2327 MUMBERT DR
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City | MANTECA
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State | CA
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Zip | 95337-7807
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Country | US
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Telephone | 408-505-7733
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 29668
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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