Provider Demographics
NPI:1174271621
Name:DANGELO, VICTORIA (LSW)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:DANGELO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 W B ST FL 4
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-3537
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3801 W SKIPPACK PIKE
Practice Address - Street 2:UNIT F
Practice Address - City:SKIPPACK
Practice Address - State:PA
Practice Address - Zip Code:19474
Practice Address - Country:US
Practice Address - Phone:215-500-1179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW138097104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker