Provider Demographics
NPI:1699323105
Name:CALLEJAS, ANGIE ALICIA (MSW)
Entity type:Individual
Prefix:
First Name:ANGIE
Middle Name:ALICIA
Last Name:CALLEJAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7068 DINWIDDIE ST
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-2003
Mailing Address - Country:US
Mailing Address - Phone:562-965-7359
Mailing Address - Fax:
Practice Address - Street 1:1516 SAN PABLO ST STE 200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-5313
Practice Address - Country:US
Practice Address - Phone:323-276-3782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical