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General NPI Number Information
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NPI Number | 1629513510
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Entity Type | Individual
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Provider Name | ANGIE BOLANOS- CASCIO PPS
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Gender | Female
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Dates
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Enumeration Date | 12/30/2016
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 2091 BUSINESS CENTER DR 150
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City | IRVINE
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State | CA
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Zip | 92612-1130
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Country | US
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Telephone | 949-250-1101
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Fax | 949-250-1103
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Provider Business Mailing Address
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Address Line | 1111 VAN NESS AVE
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City | FRESNO
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State | CA
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Zip | 93721-2002
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Country | US
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Telephone | 559-265-3000
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-16-24325
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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