Provider Demographics
NPI:1538316377
Name:BUENO, ANGELI LUCIA
Entity Type:Individual
Prefix:MISS
First Name:ANGELI
Middle Name:LUCIA
Last Name:BUENO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 TEMPLE WAY
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-4242
Mailing Address - Country:US
Mailing Address - Phone:707-554-3109
Mailing Address - Fax:
Practice Address - Street 1:408 TENNESSEE ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-4453
Practice Address - Country:US
Practice Address - Phone:707-647-1520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor