Provider Demographics
NPI:1710010319
Name:ARCANGEL, LYNNE ANN
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:ANN
Last Name:ARCANGEL
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:PO BOX 1101
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95617-1101
Mailing Address - Country:US
Mailing Address - Phone:530-758-2160
Mailing Address - Fax:530-758-1386
Practice Address - Street 1:1667 OAK AVE
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-1003
Practice Address - Country:US
Practice Address - Phone:530-758-2160
Practice Address - Fax:530-758-1386
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor