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General NPI Number Information
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NPI Number | 1376106450
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Entity Type | Individual
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Provider Name | NICHOLAS ANTHONY ANGELO LMFT 144221
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Gender | Male
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Dates
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Enumeration Date | 04/15/2019
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 2879 MAMMOTH LN
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City | PASO ROBLES
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State | CA
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Zip | 93446-4101
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Country | US
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Telephone | 760-809-7168
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Fax |
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Provider Business Mailing Address
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Address Line | 2033 SAN ELIJO AVE # 302
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City | CARDIFF
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State | CA
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Zip | 92007-1726
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Country | US
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Telephone | 442-354-4695
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 144221
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License Number State | CA
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