Provider Demographics
NPI:1487830675
Name:DELACRUZ, ANGELA MARIE
Entity Type:Individual
Prefix:MISS
First Name:ANGELA
Middle Name:MARIE
Last Name:DELACRUZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:MARIE
Other - Last Name:CRESWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6127 FAIR OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:CARMICHEAL
Mailing Address - State:CA
Mailing Address - Zip Code:95680
Mailing Address - Country:US
Mailing Address - Phone:916-974-8090
Mailing Address - Fax:916-974-7851
Practice Address - Street 1:6127 FAIR OAKS BLVD
Practice Address - Street 2:
Practice Address - City:CARMICHEAL
Practice Address - State:CA
Practice Address - Zip Code:95680
Practice Address - Country:US
Practice Address - Phone:916-974-8090
Practice Address - Fax:916-974-7851
Is Sole Proprietor?:No
Enumeration Date:2008-01-17
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)