Provider Demographics
NPI:1164561213
Name:SIMONEAU, ANGELA NADINE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:NADINE
Last Name:SIMONEAU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3177 OCEAN VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92113-1432
Mailing Address - Country:US
Mailing Address - Phone:619-595-4400
Mailing Address - Fax:619-595-7927
Practice Address - Street 1:3177 OCEAN VIEW BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92113-1432
Practice Address - Country:US
Practice Address - Phone:619-595-4400
Practice Address - Fax:619-595-7927
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS236921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical