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General NPI Number Information
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NPI Number | 1093262438
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Entity Type | Individual
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Provider Name | ROXANNA ANGULO
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Gender | Female
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 03/06/2020
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Provider Practice Location Address
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Address Line | 530 W BADILLO ST
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City | COVINA
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State | CA
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Zip | 91722-3787
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Country | US
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Telephone | 626-933-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 225 VANGUARD AVE
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City | LA PUENTE
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State | CA
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Zip | 91744-5341
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Country | US
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Telephone | 626-608-8432
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMF102413
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License Number State | CA
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 118389
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License Number State | CA
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