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General NPI Number Information
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NPI Number | 1306044474
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Entity Type | Individual
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Provider Name | ANDREA DESHIELL RAYMER CMP
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Gender | Female
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 2051 HILLTOP DR STE A5
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City | REDDING
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State | CA
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Zip | 96002-0265
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Country | US
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Telephone | 530-221-1031
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Fax | 530-221-8878
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Provider Business Mailing Address
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Address Line | 2051 HILLTOP DR STE A5
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City | REDDING
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State | CA
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Zip | 96002-0265
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Country | US
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Telephone | 530-221-1031
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Fax | 530-221-8878
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 21698
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License Number State | CA
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