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General NPI Number Information
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NPI Number | 1396480844
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Entity Type | Individual
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Provider Name | ANDY PAEK
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Gender | Male
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Dates
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Enumeration Date | 04/29/2022
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 424 2ND STREET
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City | ALAMEDA
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State | CA
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Zip | 94502
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Country | US
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Telephone | 917-208-7949
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Fax |
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Provider Business Mailing Address
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Address Line | 7089 NORTH MARIPOSA COURT DUBLIN, CA 94568
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City | SAN FRANCISCO
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State | CA
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Zip | 94568
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Country | US
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Telephone | 917-208-7949
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 142928
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License Number State | CA
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