MEDICARE: DR. ANDREW WILLIAM KNEIER PH.D.

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
1	103T00000X	Psychologist	PSY 8113	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PSY 8113	OTHER	CA	PSYCHOLOGY LICENSE NUMBER

General Provider Information

NPI Number	:	1588690184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW WILLIAM KNEIER PH.D.

Provider Business Mailing Address
First Line	:	265 GILES ST
Second Line	:
City	:	NEVADA CITY
State	:	CA
Zip	:	95959-2147
Country	:	US
Telephone Number	:	530-478-9033
Fax Number	:	415-353-9994

Provider Business Practice Location Address
First Line	:	265 GILES ST
Second Line	:
City	:	NEVADA CITY
State	:	CA
Zip	:	95959-2147
Country	:	US
Telephone Number	:	530-478-9033
Fax Number	:	415-353-9994

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	07/08/2007

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