Provider Demographics
NPI:1710431333
Name:DIN, ANGELA (LCSW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:DIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 ARENA DR
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95618-6754
Mailing Address - Country:US
Mailing Address - Phone:530-908-5987
Mailing Address - Fax:530-908-5987
Practice Address - Street 1:949 UNIVERSITY AVE STE 200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6728
Practice Address - Country:US
Practice Address - Phone:916-437-4681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS231971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical