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Angelina Koesnodihardjo
Mental Health Counselor in San Carlos, California
NPI 1225322175

Angelina Koesnodihardjo is a Mental Health Counselor based in Redwood City, CA and is specialized in Mental Health. Angelina Koesnodihardjo practices in San Carlos, CA. The NPI Number for Angelina Koesnodihardjo is 1225322175 and holds a License No. (California).

The current practice location address for Angelina Koesnodihardjo is 957 Industrial Rd, San Carlos, CA and can be reached out via phone at 415-941-1751 and via fax at 650-620-9549.

Location: 957 Industrial Rd, San Carlos, CA, 94064-0070
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1225322175
Provider Name
Angelina Koesnodihardjo
Credential
Provider Entity Type
Individual
Gender
Female
Address
957 Industrial Rd, San Carlos, CA, 94064-0070
Phone Number
415-941-1751
Fax Number
650-620-9549
Provider Enumeration Date
06/07/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
957 Industrial Rd
City
San Carlos
State
California
Zip
94070-4151
Phone Number
415-941-1751
Fax Number
650-620-9549
person
Provider Business Mailing Address Details
Address
957 Industrial Rd
City
San Carlos
State
California
Zip
94070-4151
Phone Number
415-941-1751
Fax Number
650-620-9549
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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