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General NPI Number Information
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NPI Number | 1780934109
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Entity Type | Individual
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Provider Name | ANGELA RUTHANNE KOZAK-EMBREY LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/13/2012
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 4540 FLORIN RD STE E350
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City | SACRAMENTO
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State | CA
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Zip | 95823-2536
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Country | US
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Telephone | 916-467-4201
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Fax |
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Provider Business Mailing Address
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Address Line | 4540 FLORIN RD STE E350
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City | SACRAMENTO
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State | CA
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Zip | 95823-2536
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Country | US
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Telephone | 916-467-4201
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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 | LCSW81408
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License Number State | CA
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