Individual
ANGELA DAWN EASTVOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
120 BIRMINGHAM DR STE 110A, CARDIFF BY THE SEA, CA 92007-1737
(760) 420-2640
Mailing address
120 BIRMINGHAM DR STE 110A, CARDIFF BY THE SEA, CA 92007-1737
(760) 420-2640
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
CA-29589
CA
103TC0700X
Clinical Psychologist
80249832501
UT
Other
Enumeration date
09/02/2011
Last updated
06/07/2022
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