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General NPI Number Information
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NPI Number | 1588125561
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Entity Type | Individual
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Provider Name | ANGELIKA V KULYASOVA LP
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Gender | Female
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Dates
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Enumeration Date | 03/30/2019
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 2067 W VISTA WAY STE 295
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City | VISTA
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State | CA
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Zip | 92083-6002
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Country | US
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Telephone | 619-729-6897
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Fax |
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Provider Business Mailing Address
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Address Line | 15201 DIAMONDBACK DR
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City | ROCKVILLE
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State | MD
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Zip | 20850-3312
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Country | US
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Telephone |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 40378
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License Number State | TX
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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 | PSY30564
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License Number State | CA
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