Provider Demographics
NPI:1487835088
Name:DYPIANGCO, ANN MARIE GILLETTE (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:MARIE GILLETTE
Last Name:DYPIANGCO
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MRS
Other - First Name:ANN
Other - Middle Name:MARIE
Other - Last Name:GILLETTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:PO BOX 1385
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91031-1385
Mailing Address - Country:US
Mailing Address - Phone:818-495-5814
Mailing Address - Fax:
Practice Address - Street 1:4515 OCEAN VIEW BLVD
Practice Address - Street 2:SUITE 340
Practice Address - City:LA CANADA FLINTRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91011-1438
Practice Address - Country:US
Practice Address - Phone:818-495-5814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-25
Last Update Date:2013-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS267081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical