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Individual

MR. AGUSTIN RANGEL JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
204 HAMPTON DR, VENICE, CA 90291
(310) 396-6468
Mailing address
9240 ELM VISTA DR APT A6, DOWNEY, CA 90242-5320
(323) 490-5546

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
ASW68759
CA
1041C0700X
Clinical Social Worker
ASW68759
CA
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
04/26/2016
Last updated
01/02/2019
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