Healthcare Provider Details

I. General information

NPI: 1063573251
Provider Name (Legal Business Name): ANDREA E PICCHI MS, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 01/03/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 LAS POSITAS RD
LIVERMORE CA
94551-9627
US

IV. Provider business mailing address

3787 BROOKDALE BLVD
CASTRO VALLEY CA
94546-2013
US

V. Phone/Fax

Practice location:
  • Phone: 925-243-4416
  • Fax: 925-243-4420
Mailing address:
  • Phone: 925-243-4416
  • Fax: 925-243-4420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number308682
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: