Provider Demographics
NPI:1174845036
Name:HENSLEY, ANGELINA CHRISTINE (MFT)
Entity Type:Individual
Prefix:MS
First Name:ANGELINA
Middle Name:CHRISTINE
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:C
Other - Last Name:HENSLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:2211 O ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816
Mailing Address - Country:US
Mailing Address - Phone:916-837-7404
Mailing Address - Fax:
Practice Address - Street 1:2211 O ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816
Practice Address - Country:US
Practice Address - Phone:916-837-7404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CA53177106H00000X
CALMFT53177106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)