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General NPI Number Information
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NPI Number | 1366084857
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Entity Type | Individual
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Provider Name | ANGELA T DE PASS ALBERS
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Gender | Female
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Dates
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Enumeration Date | 10/16/2019
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 900 E GILBERT STREET COTTAGE #4
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City | SAN BERNARDINO
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State | CA
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Zip | 92415-3505
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Country | US
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Telephone | 909-756-0486
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Fax |
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Provider Business Mailing Address
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Address Line | 3554 ROCKROSE DR
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City | CORONA
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State | CA
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Zip | 92882-2310
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Country | US
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Telephone | 909-730-6483
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 118770
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License Number State | CA
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