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NPI Code Detail

MEDICARE: ANDREW FRISINA

MEDICARE: ANDREW FRISINA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-17-25128CA

General Provider Information

NPI Number : 1417489204
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW FRISINA
Provider Business Mailing Address
First Line : 1230 ROSECRANS AVE STE 250
Second Line :
City : MANHATTAN BEACH
State : CA
Zip : 90266-2496
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1230 ROSECRANS AVE STE 250
Second Line :
City : MANHATTAN BEACH
State : CA
Zip : 90266-2496
Country : US
Telephone Number : 310-406-1500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2017
Last Update Date : 03/30/2017

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Directions to “ ANDREW FRISINA ” Practice Location

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