Provider Demographics
NPI:1518032986
Name:LARRIGAN, ANGELINA KRISTINE (MA, MFT)
Entity Type:Individual
Prefix:MRS
First Name:ANGELINA
Middle Name:KRISTINE
Last Name:LARRIGAN
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:ANGELINA
Other - Middle Name:KRISTINE
Other - Last Name:COLBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:768 PLEASANT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:DIAMOND SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95619
Mailing Address - Country:US
Mailing Address - Phone:530-621-6117
Mailing Address - Fax:530-303-1526
Practice Address - Street 1:768 PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:DIAMOND SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:95619
Practice Address - Country:US
Practice Address - Phone:530-621-6117
Practice Address - Fax:530-303-1526
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMF75083106H00000X
225C00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health