Provider Demographics
NPI:1992463368
Name:DI ANGELI, RITI
Entity type:Individual
Prefix:
First Name:RITI
Middle Name:
Last Name:DI ANGELI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 LA FIESTA CT
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-4730
Mailing Address - Country:US
Mailing Address - Phone:760-621-4404
Mailing Address - Fax:
Practice Address - Street 1:900 LA FIESTA CT
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-4730
Practice Address - Country:US
Practice Address - Phone:760-621-4404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool