Provider Demographics
NPI:1992931935
Name:ALBA, ANDREA JOKAY (LMT)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:JOKAY
Last Name:ALBA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:325 ROLLING OAKS DR
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1201
Mailing Address - Country:US
Mailing Address - Phone:805-230-2673
Mailing Address - Fax:805-230-2134
Practice Address - Street 1:325 ROLLING OAKS DR
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1201
Practice Address - Country:US
Practice Address - Phone:805-230-2673
Practice Address - Fax:805-230-2134
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA09-00016473111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation