Doctor Name: | MS. ANDREA JEAN DOCTOR |
NPI Number: | 1194746594 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | LSC16960 |
Business Practice Address: | 30423 Canwood St Suite 129 Agoura Hills, CA - 913012082 |
Business Phone Number: | 8184517263 |
Business Fax Number: | |
Mailing Address: | 4769 Taranto Way, OAK PARK |
State: | CA |
Postal Code: | 913775524 |
Phone Number: | 8184517263 |
Fax Number: | |
NPI Enumeration Date: | 07/21/2006 |
NPI Last Update Date: | 03/04/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LSC16960 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |