Individual
ANGELA BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27 N HUMBOLDT ST, SAN MATEO, CA 94401-2923
(650) 342-0454
(650) 342-0554
Mailing address
2015 PIONEER CT, SAN MATEO, CA 94403-1781
(650) 342-0454
(650) 342-0554
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/24/2016
Last updated
06/24/2016
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