Individual
ANGELLEE KIDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SUD COUNSELOR
Contact information
Practice address
4920 AVALON BLVD, LOS ANGELES, CA 90011-4004
(323) 638-5071
Mailing address
4920 AVALON BLVD, LOS ANGELES, CA 90011-4004
(323) 638-5071
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1620500725
CA
Other
Enumeration date
10/07/2025
Last updated
10/07/2025
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