Individual
ANGEL SAMUEL DE ANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1848 WILLOW PASS RD STE 207, CONCORD, CA 94520-2542
(530) 265-9057
(530) 292-3803
Mailing address
24077 STATE HIGHWAY 49, NEVADA CITY, CA 95959-8519
(530) 265-9057
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
10/25/2021
Last updated
04/18/2025
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