Provider Demographics
NPI:1467743476
Name:BRACAMONTES, ANEL
Entity Type:Individual
Prefix:
First Name:ANEL
Middle Name:
Last Name:BRACAMONTES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANEL
Other - Middle Name:
Other - Last Name:LOYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26137 LA PAZ RD
Mailing Address - Street 2:SUITE. 230
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-5319
Mailing Address - Country:US
Mailing Address - Phone:949-595-8610
Mailing Address - Fax:949-595-0296
Practice Address - Street 1:26137 LA PAZ RD
Practice Address - Street 2:SUITE. 230
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5319
Practice Address - Country:US
Practice Address - Phone:949-595-8610
Practice Address - Fax:949-595-0296
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health