Provider Demographics
NPI:1265284194
Name:SOBBA, ANGELA (AMFT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:SOBBA
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1089 DOHENY WAY
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-5920
Mailing Address - Country:US
Mailing Address - Phone:541-729-6355
Mailing Address - Fax:
Practice Address - Street 1:31473 RANCHO VIEJO RD STE 102
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-1862
Practice Address - Country:US
Practice Address - Phone:949-569-4575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA145656106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist