Provider Demographics
NPI:1770691644
Name:WALDROP, ANGELA E (PHD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:E
Last Name:WALDROP
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 MARKET ST STE 341
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-3022
Mailing Address - Country:US
Mailing Address - Phone:415-638-3568
Mailing Address - Fax:
Practice Address - Street 1:870 MARKET ST STE 341
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3022
Practice Address - Country:US
Practice Address - Phone:415-638-3568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23535103TC0700X
TX38862103TC0700X
CAPSY23535103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX38862OtherLICENSE
CA23535OtherLICENSE
SCPS0399Medicaid