Provider Demographics
NPI:1194550152
Name:TRIPODI, ANDRINA
Entity type:Individual
Prefix:
First Name:ANDRINA
Middle Name:
Last Name:TRIPODI
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 1:77777 COUNTRY CLUB DR APT 317
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-0467
Mailing Address - Country:US
Mailing Address - Phone:442-822-4701
Mailing Address - Fax:
Practice Address - Street 1:13525 CIELO AZUL WAY
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240-6235
Practice Address - Country:US
Practice Address - Phone:760-329-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-07
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1577310824101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)