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General NPI Number Information
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NPI Number | 1962880708
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Entity Type | Individual
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Provider Name | ANGELA FARRELL
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Gender | Female
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Dates
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Enumeration Date | 05/13/2015
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 421 E MORRIS AVE
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City | MODESTO
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State | CA
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Zip | 95354-0437
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Country | US
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Telephone | 209-525-6155
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Fax |
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Provider Business Mailing Address
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Address Line | 4008 WINCANTON RD
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City | SALIDA
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State | CA
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Zip | 95368-9722
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Country | US
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Telephone | 209-527-3270
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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 | 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 #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State | CA
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