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NPI Code Detail

MEDICARE: ROXANNA ANGULO

MEDICARE:   ROXANNA  ANGULO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistIMF102413CA
2390200000XStudent in an Organized Health Care Education/Training Program
3106H00000XMarriage & Family Therapist118389CA

General Provider Information

NPI Number : 1093262438
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROXANNA ANGULO
Provider Business Mailing Address
First Line : 225 VANGUARD AVE
Second Line :
City : LA PUENTE
State : CA
Zip : 91744-5341
Country : US
Telephone Number : 626-608-8432
Fax Number :
Provider Business Practice Location Address
First Line : 530 W BADILLO ST
Second Line :
City : COVINA
State : CA
Zip : 91722-3787
Country : US
Telephone Number : 626-933-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2016
Last Update Date : 03/06/2020

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Directions to “ ROXANNA ANGULO ” Practice Location

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