Individual
ANGELA ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT 98940
Contact information
Practice address
2901 PARK AVE STE B10, SOQUEL, CA 95073-2831
(831) 471-7165
Mailing address
PO BOX 576, FELTON, CA 95018-0576
(831) 471-7165
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
70937
CA
106H00000X
Marriage & Family Therapist
Primary
98940
CA
Other
Enumeration date
08/07/2014
Last updated
06/21/2019
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