Provider Demographics
NPI:1609331248
Name:CORTEZ, ANGELITA DOMINIQUE (LPCC)
Entity Type:Individual
Prefix:
First Name:ANGELITA
Middle Name:DOMINIQUE
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HEALTHY MINDS COUNSELING SERVICES
Mailing Address - Street 2:591 CAMINO DE LA REINA, SUITE 210
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108
Mailing Address - Country:US
Mailing Address - Phone:619-206-5271
Mailing Address - Fax:619-795-3274
Practice Address - Street 1:HEALTHY MINDS COUNSELING SERVICES
Practice Address - Street 2:591 CAMINO DE LA REINA, SUITE 210
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108
Practice Address - Country:US
Practice Address - Phone:619-206-5271
Practice Address - Fax:619-795-3274
Is Sole Proprietor?:No
Enumeration Date:2019-02-07
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6037101Y00000X
101YM0800X
NM101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor