Provider Demographics
NPI:1164761797
Name:TIMMONS, ANGELA MONTGOMERY (DPA, LCSW)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:MONTGOMERY
Last Name:TIMMONS
Suffix:
Gender:F
Credentials:DPA, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 W. ELM STREET
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033
Mailing Address - Country:US
Mailing Address - Phone:805-479-7840
Mailing Address - Fax:
Practice Address - Street 1:1429 W ELM ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-3059
Practice Address - Country:US
Practice Address - Phone:805-479-7840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA184521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical