Individual
ANGIE E ANGELES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2940 SUMMIT ST STE 2D, OAKLAND, CA 94609-3416
(510) 397-9129
Mailing address
3400 DELTA FAIR BLVD, ANTIOCH, CA 94509-4004
(925) 779-4328
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW64030
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7771
EPSDT PROVIDER NUMBER
CA
Enumeration date
06/20/2007
Last updated
01/08/2022
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