Provider Demographics
NPI:1740095009
Name:MIRAMONTES, ANGELICA MIGUEL (PPS)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:MIGUEL
Last Name:MIRAMONTES
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:ANGELICA
Other - Middle Name:
Other - Last Name:MIGUEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1111 VAN NESS AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-2002
Mailing Address - Country:US
Mailing Address - Phone:559-265-3000
Mailing Address - Fax:
Practice Address - Street 1:2910 S IVY AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-5515
Practice Address - Country:US
Practice Address - Phone:559-495-5615
Practice Address - Fax:559-495-5659
Is Sole Proprietor?:No
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool