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General NPI Number Information
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NPI Number | 1770667594
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Entity Type | Individual
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Provider Name | ANDRES SCIOLLA
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 06/15/2020
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Provider Practice Location Address
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Address Line | 3025 BEYER BLVD STE E-102
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City | SAN DIEGO
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State | CA
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Zip | 92154-3432
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Country | US
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Telephone | 619-497-6647
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Fax |
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Provider Business Mailing Address
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Address Line | 4324 CAMINITO DE LA ESCENA
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City | SAN DIEGO
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State | CA
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Zip | 92108-4219
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Country | US
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Telephone | 619-281-7198
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A69224
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License Number State | CA
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