Healthcare Provider Details

I. General information

NPI: 1083863757
Provider Name (Legal Business Name): ANDRE ALMEIDA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2008
Last Update Date: 05/07/2020
Certification Date: 05/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3322 SWEETWATER SPRINGS BLVD STE 102
SPRING VALLEY CA
91977-3142
US

IV. Provider business mailing address

3322 SWEETWATER SPRINGS BLVD STE 102
SPRING VALLEY CA
91977-3142
US

V. Phone/Fax

Practice location:
  • Phone: 858-380-4676
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: