Individual provider Active NPI

Dawn Kathleen Angelich, LMFT

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1144302142
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC31745 Issued in CA
Practice address
1341 W Bullard Ave
Suite #4
Fresno, CA 93711-2464
Phone
(559) 431-5276
Fax
(559) 431-5277
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC31745 CA Primary

Addresses

Primary practice location

1341 W Bullard Ave
Suite #4
Fresno, CA 93711-2464

Mailing address

1341 W Bullard Ave
Suite #4
Fresno, CA 93711-2464
Phone (559) 431-5276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC31745CAMDMarriage & Family Therapist
31745CAMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144302142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 W BULLARD AVE",
            "address_2": "SUITE #4",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937112464",
            "telephone_number": "559-431-5276",
            "fax_number": "559-431-5277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 W BULLARD AVE",
            "address_2": "SUITE #4",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937112464",
            "telephone_number": "559-431-5276",
            "fax_number": "559-431-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELICH",
        "first_name": "DAWN",
        "middle_name": "KATHLEEN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC31745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.