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General NPI Number Information
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NPI Number | 1497907836
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Entity Type | Individual
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Provider Name | ANDREA MAR MA, MFT
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Gender | Female
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 1600 S MAIN ST SUITE 240
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City | WALNUT CREEK
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State | CA
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Zip | 94596-5340
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Country | US
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Telephone | 925-826-3850
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 20281
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City | OAKLAND
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State | CA
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Zip | 94620-0281
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Country | US
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Telephone | 925-826-3850
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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 | MFC35181
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License Number State | CA
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