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General NPI Number Information
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NPI Number | 1922664515
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Entity Type | Individual
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Provider Name | CLARICE ANN D'ANGELO
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Gender | Female
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Dates
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Enumeration Date | 05/20/2019
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Last Update Date | 05/20/2019
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Provider Practice Location Address
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Address Line | 1926 BEVERLY BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90057-2402
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Country | US
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Telephone | 213-353-1140
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Fax |
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Provider Business Mailing Address
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Address Line | 3583 GLENROSE AVE
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City | ALTADENA
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State | CA
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Zip | 91001-3914
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Country | US
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Telephone | 626-840-0130
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | CA
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