Provider Demographics
NPI:1750534673
Name:ANGSTEN, JOANNA F (PSYD)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:F
Last Name:ANGSTEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2698 MATARO ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3416
Mailing Address - Country:US
Mailing Address - Phone:626-773-3311
Mailing Address - Fax:626-773-3334
Practice Address - Street 1:3921 WILSHIRE BLVD
Practice Address - Street 2:SUITE # 200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-3317
Practice Address - Country:US
Practice Address - Phone:626-773-3311
Practice Address - Fax:626-773-3334
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 12854103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical