Provider Demographics
NPI:1851908313
Name:MOREAU, ANGELA M
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:M
Last Name:MOREAU
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 1:1266 LASSEN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ALMANOR
Mailing Address - State:CA
Mailing Address - Zip Code:96137-9541
Mailing Address - Country:US
Mailing Address - Phone:530-394-8010
Mailing Address - Fax:
Practice Address - Street 1:612 FIRST STREET
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:CA
Practice Address - Zip Code:96020-0797
Practice Address - Country:US
Practice Address - Phone:530-258-2126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator