Provider Demographics
NPI:1730219197
Name:DANDREA, ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:
Last Name:DANDREA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1334 WESTWOOD BLVD
Mailing Address - Street 2:STE # 1
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-4951
Mailing Address - Country:US
Mailing Address - Phone:310-474-2427
Mailing Address - Fax:
Practice Address - Street 1:1334 WESTWOOD BLVD
Practice Address - Street 2:STE # 1
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-4951
Practice Address - Country:US
Practice Address - Phone:310-474-2427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8185103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist