Provider Demographics
NPI:1720128754
Name:COMBS, ANGELICA SILVIA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ANGELICA
Middle Name:SILVIA
Last Name:COMBS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANGELICA
Other - Middle Name:SILVIA
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:850 E FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-5230
Mailing Address - Country:US
Mailing Address - Phone:909-421-9380
Mailing Address - Fax:909-421-9494
Practice Address - Street 1:850 E FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-5230
Practice Address - Country:US
Practice Address - Phone:909-421-9495
Practice Address - Fax:909-421-9494
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA239391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical