Provider Demographics
NPI:1134316532
Name:JOSEPH, ANGELA MICHELLE (AMFT)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:MICHELLE
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:MS
Other - First Name:ANGELA
Other - Middle Name:MICHELLE
Other - Last Name:MAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AMFT
Mailing Address - Street 1:1010 HELEN POWER DR # 1058
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-3504
Mailing Address - Country:US
Mailing Address - Phone:510-730-3928
Mailing Address - Fax:
Practice Address - Street 1:4605 APRIL CT
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-6378
Practice Address - Country:US
Practice Address - Phone:707-980-6875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105236106H00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program