Healthcare Provider Details

I. General information

NPI: 1790505311
Provider Name (Legal Business Name): ANDY CHAU MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 09/11/2025
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1345 SUNSET DR
VISTA CA
92081-6528
US

IV. Provider business mailing address

3400 COTTAGE WAY STE G2
SACRAMENTO CA
95825-1474
US

V. Phone/Fax

Practice location:
  • Phone: 760-917-0699
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: