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General NPI Number Information
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NPI Number | 1396993127
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Entity Type | Individual
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Provider Name | WRAY E DE ANDA PSY.D
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Gender | Female
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Dates
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Enumeration Date | 09/04/2008
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Last Update Date | 02/28/2019
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Provider Practice Location Address
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Address Line | 13601 WHITTIER BLVD STE 310
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City | WHITTIER
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State | CA
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Zip | 90605-1969
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Country | US
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Telephone | 714-623-0997
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Fax |
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Provider Business Mailing Address
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Address Line | 1940 W ORANGEWOOD AVE SUITE 110-4
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City | ORANGE
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State | CA
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Zip | 92868-2009
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Country | US
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Telephone | 714-623-0997
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY-25484
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License Number State | CA
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