Individual ProviderAngel De Los AngelesSocial WorkerBehavioral Health & Social Service ProvidersPractice Address160 E Virginia St Ste 280, San Jose, CA 95112-5817(408) 938-2113PECOS EnrollmentBased on the most recent information from CMS, provider Angel De Los Angeles 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 2 days ago.Profile DetailsProvider ID1730854910Provider TypeIndividualFull NameDe Los Angeles, AngelGenderMaleSole ProprietorNoEnumeration Date8/10/2021Last Updated8/4/2023Contact InformationPractice LocationPractice Address160 E Virginia St Ste 280, San Jose, CA 95112-5817Phone(408) 938-2113Fax(408) 579-6143Mailing LocationMailing Address160 E Virginia St. Ste 280, San Jose, CA 95112-5817Phone(408) 938-2113Fax(408) 579-6143Provider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense116997California