Healthcare Provider Details

I. General information

NPI: 1104750272
Provider Name (Legal Business Name): ANDREA CLAREY CADC, BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

20 CENTERPOINTE DR
LA PALMA CA
90623-2505
US

IV. Provider business mailing address

3635 E 1ST ST APT 411
LONG BEACH CA
90803-2738
US

V. Phone/Fax

Practice location:
  • Phone: 206-229-5186
  • Fax:
Mailing address:
  • Phone: 206-229-5186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberA061380622
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: