Provider Demographics
NPI:1063608073
Name:ANDRADE, IRMA
Entity type:Individual
Prefix:
First Name:IRMA
Middle Name:
Last Name:ANDRADE
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 1:792 W TOWN AND COUNTRY RD BLDG E
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4710
Mailing Address - Country:US
Mailing Address - Phone:714-480-5100
Mailing Address - Fax:714-836-5801
Practice Address - Street 1:792 W TOWN AND COUNTRY RD BLDG E
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4710
Practice Address - Country:US
Practice Address - Phone:714-480-5100
Practice Address - Fax:714-836-5801
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health