Provider Demographics
NPI:1073005864
Name:FRANCO, ANGELA LIZBETH
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:LIZBETH
Last Name:FRANCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 CASA SAN CARLOS LN APT C
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-4226
Mailing Address - Country:US
Mailing Address - Phone:805-749-6975
Mailing Address - Fax:
Practice Address - Street 1:1411 CASA SAN CARLOS LN APT C
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-4226
Practice Address - Country:US
Practice Address - Phone:805-749-6975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAY4305518OtherNONE