MEDICARE: DR. ANN DANDREA PHD

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	PSY8185	CA

General Provider Information

NPI Number	:	1730219197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANN DANDREA PHD

Provider Business Mailing Address
First Line	:	1334 WESTWOOD BLVD
Second Line	:	STE # 1
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4951
Country	:	US
Telephone Number	:	310-474-2427
Fax Number	:

Provider Business Practice Location Address
First Line	:	1334 WESTWOOD BLVD
Second Line	:	STE # 1
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4951
Country	:	US
Telephone Number	:	310-474-2427
Fax Number	:

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	07/08/2007

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