Provider Demographics
NPI:1154135739
Name:ANGULO, SARAH ANDRADE (MO)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANDRADE
Last Name:ANGULO
Suffix:
Gender:F
Credentials:MO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2432 CESAR CORDOVA PL
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-2385
Mailing Address - Country:US
Mailing Address - Phone:254-421-9400
Mailing Address - Fax:
Practice Address - Street 1:BLDG 2485-A
Practice Address - Street 2:
Practice Address - City:FORT BLISS
Practice Address - State:TX
Practice Address - Zip Code:79906
Practice Address - Country:US
Practice Address - Phone:915-742-2121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025001665104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker