MEDICARE: ANGIE ARTEAGA

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
1	101YM0800X	Mental Health Counselor
2	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1427616424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGIE ARTEAGA

Provider Business Mailing Address
First Line	:	380 ENCINAL ST STE 200
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95060-2178
Country	:	US
Telephone Number	:	831-469-1700
Fax Number	:	831-425-1905

Provider Business Practice Location Address
First Line	:	4468 CESAR CHAVEZ BLVD, BUILDING 340
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93702
Country	:	US
Telephone Number	:	559-600-6073
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2019
Last Update Date	:	09/17/2024

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Directions to “ ANGIE ARTEAGA ” Practice Location

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