Provider Demographics
NPI:1013198043
Name:CAPUYAN MENDOZA, ANGELINA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:ANGELINA
Middle Name:
Last Name:CAPUYAN MENDOZA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:ANGELINA
Other - Middle Name:JUSTINA
Other - Last Name:CAPUYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:4150 CLEMENT ST
Mailing Address - Street 2:SOCIAL WORK SERVICES-122
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-1545
Mailing Address - Country:US
Mailing Address - Phone:415-221-4810
Mailing Address - Fax:415-750-2078
Practice Address - Street 1:4150 CLEMENT ST
Practice Address - Street 2:SOCIAL WORK SERVICES-122
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1545
Practice Address - Country:US
Practice Address - Phone:415-221-4810
Practice Address - Fax:415-750-2078
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA223911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical