Provider Demographics
NPI:1982026126
Name:ANGELONI, JOEY (BS)
Entity Type:Individual
Prefix:
First Name:JOEY
Middle Name:
Last Name:ANGELONI
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 ORANGE ST
Mailing Address - Street 2:2
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-4141
Mailing Address - Country:US
Mailing Address - Phone:510-866-6300
Mailing Address - Fax:
Practice Address - Street 1:900 5TH AVE
Practice Address - Street 2:150
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-2959
Practice Address - Country:US
Practice Address - Phone:415-457-6964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health