Provider Demographics
NPI:1164183539
Name:HORNG, ANGELA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:HORNG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:643 BAIR ISLAND RD STE 402
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-2758
Mailing Address - Country:US
Mailing Address - Phone:650-424-0852
Mailing Address - Fax:
Practice Address - Street 1:1921 RANDALL AVE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5508
Practice Address - Country:US
Practice Address - Phone:408-507-0102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33025103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY33025OtherCALIFORNIA BOARD OF PSYCHOLOGY