Provider Demographics
NPI:1437287471
Name:DEYHIMY, ANGELA B (LCSW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:B
Last Name:DEYHIMY
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 1:33 HOLLYLEAF
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-2129
Mailing Address - Country:US
Mailing Address - Phone:949-870-5071
Mailing Address - Fax:
Practice Address - Street 1:26441 CROWN VALLEY PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-8528
Practice Address - Country:US
Practice Address - Phone:949-870-5071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 208661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical