Provider Demographics
NPI:1053945212
Name:REESE-GALLOWAY, ANGELIA MARIA (MSW, ASW, PH D-ABD)
Entity type:Individual
Prefix:
First Name:ANGELIA
Middle Name:MARIA
Last Name:REESE-GALLOWAY
Suffix:
Gender:F
Credentials:MSW, ASW, PH D-ABD
Other - Prefix:
Other - First Name:ANGEL
Other - Middle Name:
Other - Last Name:REESE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, ASW, PHD
Mailing Address - Street 1:3000 CITRUS CIR STE 220
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2665
Mailing Address - Country:US
Mailing Address - Phone:925-689-5811
Mailing Address - Fax:925-429-9254
Practice Address - Street 1:3000 CITRUS CIR STE 220
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2665
Practice Address - Country:US
Practice Address - Phone:925-689-5811
Practice Address - Fax:925-429-9254
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA909071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical