Provider Demographics
NPI:1609310028
Name:FLORES, ANGELA
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:FLORES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 CARMEN LN STE 201
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-7771
Mailing Address - Country:US
Mailing Address - Phone:805-212-7680
Mailing Address - Fax:805-728-9492
Practice Address - Street 1:212 CARMEN LANE SUITE 201
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458
Practice Address - Country:US
Practice Address - Phone:805-212-7680
Practice Address - Fax:805-728-9492
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-05
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15263101YA0400X
101YA0400X, 171M00000X, 172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator