Provider Demographics
NPI:1609650464
Name:ESCOBAR MONROY, ANGELA MARLENY
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARLENY
Last Name:ESCOBAR MONROY
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 1:6633 YUCCA APT 105
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-4104
Mailing Address - Country:US
Mailing Address - Phone:323-868-0931
Mailing Address - Fax:
Practice Address - Street 1:6633 YUCCA APT 105
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-4104
Practice Address - Country:US
Practice Address - Phone:323-868-0931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health