Healthcare Provider Details

I. General information

NPI: 1023937828
Provider Name (Legal Business Name): MEGAN D'ANDREA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 BUENA VISTA TER APT 18
SAN FRANCISCO CA
94117-4149
US

IV. Provider business mailing address

169 BUENA VISTA TER APT 18
SAN FRANCISCO CA
94117-4149
US

V. Phone/Fax

Practice location:
  • Phone: 650-380-5772
  • Fax:
Mailing address:
  • Phone: 650-380-5772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number164471
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: