Healthcare Provider Details

I. General information

NPI: 1720903602
Provider Name (Legal Business Name): MR. ANDREW IWAHASHI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 AUTUMN LN
LOS ALTOS CA
94024-6035
US

IV. Provider business mailing address

1070 AUTUMN LN
LOS ALTOS CA
94024-6035
US

V. Phone/Fax

Practice location:
  • Phone: 408-516-6233
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: