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General NPI Number Information
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NPI Number | 1861995532
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Entity Type | Individual
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Provider Name | MISS ANGELICA GODINEZ
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Gender | Female
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Dates
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Enumeration Date | 03/08/2018
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 160 S 7TH AVE
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City | LA PUENTE
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State | CA
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Zip | 91746-3211
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Country | US
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Telephone | 626-961-8971
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Fax |
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Provider Business Mailing Address
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Address Line | 24671 STANDING ROCK RD
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City | APPLE VALLEY
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State | CA
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Zip | 92307-6506
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Country | US
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Telephone | 760-985-7077
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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 | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | B00002550722
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 144458
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License Number State | CA
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