Provider Demographics
NPI:1487489431
Name:CAPCINO, ANGELINA MARIA
Entity type:Individual
Prefix:
First Name:ANGELINA
Middle Name:MARIA
Last Name:CAPCINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 SAN DIEGO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-2928
Mailing Address - Country:US
Mailing Address - Phone:619-642-3391
Mailing Address - Fax:
Practice Address - Street 1:2121 SAN DIEGO AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-2928
Practice Address - Country:US
Practice Address - Phone:619-642-3391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty