Individual
ANGELA GRETCHENUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15305 RAYEN ST, NORTH HILLS, CA 91343-5117
(818) 892-3423
(818) 893-4509
Mailing address
15305 RAYEN ST, NORTH HILLS, CA 91343-5117
(818) 402-6098
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ASW123656
CA
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-2633765
MEDI-CAL
CA
Enumeration date
02/01/2023
Last updated
07/30/2024
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