Provider Demographics
NPI:1962419135
Name:ANDREWS, LUAN (MA, MFT)
Entity type:Individual
Prefix:
First Name:LUAN
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3252 HOLIDAY CT STE 106
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1807
Mailing Address - Country:US
Mailing Address - Phone:858-552-8181
Mailing Address - Fax:
Practice Address - Street 1:3252 HOLIDAY CT STE 106
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1807
Practice Address - Country:US
Practice Address - Phone:858-552-8181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC19321106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist