Provider Demographics
NPI:1871877514
Name:KRUMM, ANGELA (PHD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:KRUMM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 SOLACE PL STE D2
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4337
Mailing Address - Country:US
Mailing Address - Phone:650-417-3564
Mailing Address - Fax:
Practice Address - Street 1:4966 EL CAMINO REAL STE 119
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-1406
Practice Address - Country:US
Practice Address - Phone:408-726-3091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21710103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling