Provider Demographics
NPI:1235957127
Name:LI, ANGEL (MSW-TRAINEE)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:MSW-TRAINEE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 W MAIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-1951
Mailing Address - Country:US
Mailing Address - Phone:626-248-1800
Mailing Address - Fax:626-248-1899
Practice Address - Street 1:1635 W MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-1951
Practice Address - Country:US
Practice Address - Phone:626-248-1800
Practice Address - Fax:626-248-1899
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program