Provider Demographics
NPI:1396998100
Name:CHIODO, ANGELA ANN (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:ANN
Last Name:CHIODO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2893 E SIERRA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-0905
Mailing Address - Country:US
Mailing Address - Phone:520-261-3134
Mailing Address - Fax:
Practice Address - Street 1:2893 E SIERRA VISTA RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-0905
Practice Address - Country:US
Practice Address - Phone:202-261-3134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6943103T00000X, 103TC0700X
AZPSY-004852103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ339691Medicaid
FL000694900Medicaid