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General NPI Number Information
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NPI Number | 1457976466
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Entity Type | Individual
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Provider Name | ANGEL ETERNITY USCANGA
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Gender | Female
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Dates
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Enumeration Date | 06/15/2020
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 4700 W SUNSET BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90027-6082
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Country | US
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Telephone | 323-783-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 1308 E COLORADO BLVD # 2103
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City | PASADENA
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State | CA
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Zip | 91106-1932
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Country | US
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Telephone | 323-783-5150
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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 | 149101
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License Number State | CA
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