Healthcare Provider Details

I. General information

NPI: 1982348702
Provider Name (Legal Business Name): LAUREN DOROTHEA D'ANDREA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 VILLA LA JOLLA DR STE C101
LA JOLLA CA
92037-1727
US

IV. Provider business mailing address

8950 VILLA LA JOLLA DR STE C101
LA JOLLA CA
92037-1727
US

V. Phone/Fax

Practice location:
  • Phone: 619-543-5221
  • Fax:
Mailing address:
  • Phone: 619-543-5221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA192110
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: