Provider Demographics
NPI:1306678875
Name:DILLINGHAM-TAYLOR, ANGEL
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:DILLINGHAM-TAYLOR
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 1:14 CERES CIR
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1409
Mailing Address - Country:US
Mailing Address - Phone:530-519-6479
Mailing Address - Fax:
Practice Address - Street 1:2145 5TH AVE
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-5870
Practice Address - Country:US
Practice Address - Phone:530-534-5394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA124441101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor