Provider Demographics
NPI:1306133418
Name:GOLDSTEIN, ANDREA RENEE (NP)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:RENEE
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11525 OHIO AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-3017
Mailing Address - Country:US
Mailing Address - Phone:310-479-3975
Mailing Address - Fax:310-966-9023
Practice Address - Street 1:660 S FAIR OAKS AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2616
Practice Address - Country:US
Practice Address - Phone:626-397-5820
Practice Address - Fax:626-397-5827
Is Sole Proprietor?:No
Enumeration Date:2011-07-09
Last Update Date:2011-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA17659363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health