Provider Demographics
NPI:1104445840
Name:BRARD, ANDREA ELIZABETH (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:ELIZABETH
Last Name:BRARD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 SAN VICENTE BLVD APT 18
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90402-1523
Mailing Address - Country:US
Mailing Address - Phone:818-792-6485
Mailing Address - Fax:
Practice Address - Street 1:211 SAN VICENTE BLVD APT 18
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90402-1523
Practice Address - Country:US
Practice Address - Phone:818-792-6485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-13
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31745103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty