Healthcare Provider Details

I. General information

NPI: 1669099529
Provider Name (Legal Business Name): ANDREW ALTSCHULD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2020
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CONCORD AVE STE 100
CONCORD CA
94520-4969
US

IV. Provider business mailing address

1200 CONCORD AVE STE 100
CONCORD CA
94520-4969
US

V. Phone/Fax

Practice location:
  • Phone: 510-832-4383
  • Fax:
Mailing address:
  • Phone: 510-832-4383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-84857
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: