Provider Demographics
NPI:1679974554
Name:ANGEL, YESENIA GUADALUPE
Entity type:Individual
Prefix:MS
First Name:YESENIA
Middle Name:GUADALUPE
Last Name:ANGEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 NAPA VALLEY CORPORATE DR # A211
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-6216
Mailing Address - Country:US
Mailing Address - Phone:707-366-5492
Mailing Address - Fax:707-299-2165
Practice Address - Street 1:560 COHASSET RD
Practice Address - Street 2:SUITE 175
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2212
Practice Address - Country:US
Practice Address - Phone:530-891-3277
Practice Address - Fax:530-879-3823
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-10
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program