Provider Demographics
NPI:1679695464
Name:ANGEL STEPS
Entity type:Organization
Organization Name:ANGEL STEPS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FACKLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-327-5827
Mailing Address - Street 1:PO BOX 12200
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93389
Mailing Address - Country:US
Mailing Address - Phone:661-327-5827
Mailing Address - Fax:661-395-0588
Practice Address - Street 1:1522 18TH ST
Practice Address - Street 2:STE 210
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-4448
Practice Address - Country:US
Practice Address - Phone:661-327-5827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1994604101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty