Individual ProviderAngela DavisMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address4132 Katella Ave Ste 104, Los Alamitos, CA 90720-3493(615) 587-7595PECOS EnrollmentBased on the most recent information from CMS, provider Angela Davis does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1770937187Provider TypeIndividualFull NameDavis, AngelaGenderFemaleSole ProprietorYesEnumeration Date4/21/2016Last Updated10/16/2019Contact InformationPractice LocationPractice Address4132 Katella Ave Ste 104, Los Alamitos, CA 90720-3493Phone(615) 587-7595FaxUnlisted FaxMailing LocationMailing Address4132 Katella Ave Ste 104, Los Alamitos, CA 90720-3493Phone(615) 587-7595FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicense99815California