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NPI Code Detail

MEDICARE: ANDREA NIBOLI

MEDICARE: ANDREA NIBOLI
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
1106H00000XMarriage & Family Therapist1225151624CA

General Provider Information

NPI Number : 1740129477
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA NIBOLI
Provider Business Mailing Address
First Line : 601 11TH AVE UNIT 1516
Second Line :
City : SAN DIEGO
State : CA
Zip : 92101-7887
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2865 LOGAN AVE UNIT 1516
Second Line :
City : SAN DIEGO
State : CA
Zip : 92113-2411
Country : US
Telephone Number : 619-232-4357
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2026
Last Update Date : 03/27/2026

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Directions to “ ANDREA NIBOLI ” Practice Location

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