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General NPI Number Information
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NPI Number | 1326701582
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Entity Type | Individual
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Provider Name | MS. ANALISA M ANDRUS
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Gender | Female
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Dates
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Enumeration Date | 10/14/2021
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Last Update Date | 10/14/2021
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Provider Practice Location Address
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Address Line | 1335 S COAST HWY
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-3117
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Country | US
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Telephone | 949-494-6928
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Fax |
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Provider Business Mailing Address
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Address Line | 24361 EL TORO RD STE 215
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City | LAGUNA WOODS
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State | CA
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Zip | 92637-2757
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Country | US
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Telephone | 949-494-6928
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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