Provider Demographics
NPI:1255888517
Name:METSERS, ANGELINA
Entity type:Individual
Prefix:MRS
First Name:ANGELINA
Middle Name:
Last Name:METSERS
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 1:1750 CIRBY WAY
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-5520
Mailing Address - Country:US
Mailing Address - Phone:916-786-8676
Mailing Address - Fax:
Practice Address - Street 1:1750 CIRBY WAY
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-5520
Practice Address - Country:US
Practice Address - Phone:916-786-8676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-04
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95026101YM0800X
CA119192101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health