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General NPI Number Information
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NPI Number | 1366647133
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Entity Type | Individual
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Provider Name | ANGIE E ANGELES LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/20/2007
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Last Update Date | 01/08/2022
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Provider Practice Location Address
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Address Line | 2940 SUMMIT ST STE 2D
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City | OAKLAND
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State | CA
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Zip | 94609-3416
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Country | US
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Telephone | 510-397-9129
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Fax |
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Provider Business Mailing Address
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Address Line | 3400 DELTA FAIR BLVD
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City | ANTIOCH
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State | CA
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Zip | 94509-4004
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Country | US
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Telephone | 925-779-4328
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW64030
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License Number State | CA
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