Provider Demographics
NPI:1932533320
Name:MACDONALD, ANGELA CELINE (MS, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:CELINE
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:ANGELINA
Other - Middle Name:
Other - Last Name:MACDONALD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, BCBA
Mailing Address - Street 1:5762 BOLSA AVE
Mailing Address - Street 2:101
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-1172
Mailing Address - Country:US
Mailing Address - Phone:714-292-2322
Mailing Address - Fax:
Practice Address - Street 1:5762 BOLSA AVE
Practice Address - Street 2:101
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-1172
Practice Address - Country:US
Practice Address - Phone:714-292-2322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-13-13292103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst