Provider Demographics
NPI:1255491056
Name:SCHILZ, ANGELA MARIA (MFT)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:MARIA
Last Name:SCHILZ
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:ANGELA
Other - Middle Name:MARIA
Other - Last Name:ROFFREDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2015 21ST ST
Mailing Address - Street 2:#202
Mailing Address - City:SACROMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-1752
Mailing Address - Country:US
Mailing Address - Phone:916-452-2430
Mailing Address - Fax:
Practice Address - Street 1:2015 21ST ST
Practice Address - Street 2:#202
Practice Address - City:SACROMENTO
Practice Address - State:CA
Practice Address - Zip Code:95818-1752
Practice Address - Country:US
Practice Address - Phone:916-452-2430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC30948106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
066658OtherMANAGED HEALTH NETWORK
1178793OtherAETNA
1031235OtherCIGNA BEHAVIORAL HEALTH