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General NPI Number Information
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NPI Number | 1194496828
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Entity Type | Individual
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Provider Name | MARISA ANDREWS M.A.
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Gender | Female
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Dates
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Enumeration Date | 09/22/2021
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 1540 EUREKA RD STE 100
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City | ROSEVILLE
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State | CA
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Zip | 95661-3056
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Country | US
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Telephone | 530-722-2233
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Fax |
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Provider Business Mailing Address
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Address Line | 2580 VICTOR AVE STE C
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City | REDDING
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State | CA
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Zip | 96002-1455
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Country | US
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Telephone | 530-722-9092
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 137100
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | CA
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