Provider Demographics
NPI:1568262251
Name:OCASIO, ANGELA A (LCSW)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:A
Last Name:OCASIO
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31630 RAILROAD CANYON RD STE 2
Mailing Address - Street 2:
Mailing Address - City:CANYON LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:92587-9478
Mailing Address - Country:US
Mailing Address - Phone:951-216-3077
Mailing Address - Fax:
Practice Address - Street 1:31630 RAILROAD CANYON RD STE 2
Practice Address - Street 2:
Practice Address - City:CANYON LAKE
Practice Address - State:CA
Practice Address - Zip Code:92587-9478
Practice Address - Country:US
Practice Address - Phone:951-216-3077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1291301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical