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General NPI Number Information
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NPI Number | 1720020407
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Entity Type | Individual
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Provider Name | BRIAN S. ANDRES PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 11/04/2013
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Provider Practice Location Address
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Address Line | 1600 9TH STREET SUITE 416
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City | SACRAMENTO
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State | CA
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Zip | 95814
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Country | US
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Telephone | 415-497-5438
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4588
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City | EL DORADO HILLS
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State | CA
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Zip | 95762
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Country | US
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Telephone | 415-497-5438
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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 | PSY19522
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY866
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License Number State | HI
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