Individual
ANGELA TUCKERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6055 E WASHINGTON BLVD, SUITE 900, COMMERCE, CA 90040-2449
(323) 346-0960
(323) 346-0966
Mailing address
6055 E WASHINGTON BLVD, SUITE 900, COMMERCE, CA 90040-2449
(323) 346-0960
(323) 346-0966
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
66966
CA
101YM0800X
Mental Health Counselor
—
—
225400000X
Rehabilitation Practitioner
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/09/2014
Last updated
11/09/2017
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