MEDICARE: ANDREW PFLUEGER LMFT

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	106H00000X	Marriage & Family Therapist	61711	CA

General Provider Information

NPI Number	:	1801224654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW PFLUEGER LMFT

Provider Business Mailing Address
First Line	:	230 MOUNT HERMON RD
Second Line	:	STE 202
City	:	SCOTTS VALLEY
State	:	CA
Zip	:	95066-4034
Country	:	US
Telephone Number	:	831-234-1814
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 MOUNT HERMON RD
Second Line	:	STE 202
City	:	SCOTTS VALLEY
State	:	CA
Zip	:	95066-4034
Country	:	US
Telephone Number	:	831-234-1814
Fax Number	:

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

Provider Enumeration Date	:	10/14/2013
Last Update Date	:	03/29/2017

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