Provider Demographics
NPI:1013055839
Name:LOCH, ANGELINE NICOLE (LCSW)
Entity Type:Individual
Prefix:
First Name:ANGELINE
Middle Name:NICOLE
Last Name:LOCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANGELINE
Other - Middle Name:
Other - Last Name:BAEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:310 E GRAND AVE
Mailing Address - Street 2:APT. 202
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-3874
Mailing Address - Country:US
Mailing Address - Phone:909-732-2880
Mailing Address - Fax:
Practice Address - Street 1:2116 ARLINGTON AVE STE 100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90018-1353
Practice Address - Country:US
Practice Address - Phone:323-334-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical