Basic Information
| Provider Information | |||||||||
| NPI: | 1205278181 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NEWMAN | ||||||||
| FirstName: | ANGELICA | ||||||||
| MiddleName: | LYNN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1941 LA COSTA CT | ||||||||
| Address2: | |||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953400705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2096319619 | ||||||||
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| Practice Location | |||||||||
| Address1: | 550 PATTERSON BLVD | ||||||||
| Address2: | |||||||||
| City: | PLEASANT HILL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945234155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9259388050 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2013 | ||||||||
| LastUpdateDate: | 02/07/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator | 106H00000X | 191882 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.