Provider Demographics
NPI:1649747619
Name:CASARES, ANGELITA (LMFT)
Entity Type:Individual
Prefix:
First Name:ANGELITA
Middle Name:
Last Name:CASARES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 E PROSPERITY AVE # 908
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-8029
Mailing Address - Country:US
Mailing Address - Phone:559-202-3637
Mailing Address - Fax:
Practice Address - Street 1:260 N SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-3526
Practice Address - Country:US
Practice Address - Phone:559-202-3637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA98319106H00000X
CA126942106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist