Provider Demographics
NPI:1649589532
Name:CAZARES, ANGELINA (MSW)
Entity Type:Individual
Prefix:
First Name:ANGELINA
Middle Name:
Last Name:CAZARES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 OHIO AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-4786
Mailing Address - Country:US
Mailing Address - Phone:562-856-5467
Mailing Address - Fax:
Practice Address - Street 1:500 S MAIN ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4507
Practice Address - Country:US
Practice Address - Phone:714-543-4333
Practice Address - Fax:714-955-6590
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
CA339281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker