Provider Demographics
NPI:1669196333
Name:AUSTRIA, MA ANGELA FERNANDEZ
Entity type:Individual
Prefix:
First Name:MA ANGELA
Middle Name:FERNANDEZ
Last Name:AUSTRIA
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 1:12724 LAKE CITY WAY NE APT A306
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4445
Mailing Address - Country:US
Mailing Address - Phone:510-329-3851
Mailing Address - Fax:
Practice Address - Street 1:19031 33RD AVE W STE A
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4731
Practice Address - Country:US
Practice Address - Phone:510-329-3851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician