Healthcare Provider Details

I. General information

NPI: 1700602810
Provider Name (Legal Business Name): ANDREA MARIE CARO PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2024
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2557 MOWRY AVE STE 25
FREMONT CA
94538-1614
US

IV. Provider business mailing address

2557 MOWRY AVE STE 25
FREMONT CA
94538-1614
US

V. Phone/Fax

Practice location:
  • Phone: 510-797-4111
  • Fax:
Mailing address:
  • Phone: 510-797-4111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberPA65855
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA65855
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: