Provider Demographics
NPI:1427782218
Name:MAULUCCI, ANGELICA (LCSW)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:
Last Name:MAULUCCI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 S BASCOM AVE STE 1014
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-3537
Mailing Address - Country:US
Mailing Address - Phone:413-588-1764
Mailing Address - Fax:
Practice Address - Street 1:950 S BASCOM AVE STE 1014
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3537
Practice Address - Country:US
Practice Address - Phone:413-588-1764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-15
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1080381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical