Provider Demographics
NPI:1649832312
Name:AMARO, ANGEL
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:AMARO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 S B ST
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3609
Mailing Address - Country:US
Mailing Address - Phone:888-265-9114
Mailing Address - Fax:
Practice Address - Street 1:130 S B ST
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3609
Practice Address - Country:US
Practice Address - Phone:888-265-9114
Practice Address - Fax:714-486-1629
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical