Provider Demographics
NPI:1396458964
Name:PELAYO-PRESCOTT, ANGELA DEVI (MA)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:DEVI
Last Name:PELAYO-PRESCOTT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 E GARVEY AVE N
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-1540
Mailing Address - Country:US
Mailing Address - Phone:626-515-6189
Mailing Address - Fax:
Practice Address - Street 1:2235 E GARVEY AVE N
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-1540
Practice Address - Country:US
Practice Address - Phone:626-515-6189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)