Provider Demographics
NPI:1154537207
Name:WURTZEL, ANGELA RENEE (MA, MFT)
Entity type:Individual
Prefix:MISS
First Name:ANGELA
Middle Name:RENEE
Last Name:WURTZEL
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 E VICTORIA ST
Mailing Address - Street 2:REAR COTTAGE
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2619
Mailing Address - Country:US
Mailing Address - Phone:805-884-9794
Mailing Address - Fax:805-884-9794
Practice Address - Street 1:27 E VICTORIA ST
Practice Address - Street 2:REAR COTTAGE
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2619
Practice Address - Country:US
Practice Address - Phone:805-884-9794
Practice Address - Fax:805-884-9794
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33686106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist