Provider Demographics
NPI:1508664087
Name:ANGEL, ASHLEY (PPS)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:ANGEL
Suffix:
Gender:
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 W EAST AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-7238
Mailing Address - Country:US
Mailing Address - Phone:308-797-4835
Mailing Address - Fax:530-879-7490
Practice Address - Street 1:450 W EAST AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-7238
Practice Address - Country:US
Practice Address - Phone:530-879-7483
Practice Address - Fax:530-879-7490
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220231158101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool