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General NPI Number Information
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NPI Number | 1235175316
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Entity Type | Individual
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Provider Name | ANGELA COPELAND PSYD
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Gender | Female
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 04/25/2021
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Provider Practice Location Address
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Address Line | 1761 HOTEL CIR S STE 120
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City | SAN DIEGO
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State | CA
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Zip | 92108-3318
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Country | US
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Telephone | 760-449-1888
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Fax | 619-292-0300
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Provider Business Mailing Address
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Address Line | 8697 LA MESA BLVD STE C174
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City | LA MESA
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State | CA
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Zip | 91942-9565
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Country | US
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Telephone | 760-449-1888
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Fax | 619-292-0300
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY22974
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License Number State | CA
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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 | MFC39137
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY22974
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License Number State | CA
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