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General NPI Number Information
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NPI Number | 1912132937
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Entity Type | Individual
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Provider Name | ANDREW LAST LMFT
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Gender | Male
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 03/04/2019
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Provider Practice Location Address
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Address Line | 2635 CAMINO DEL RIO S STE 211
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City | SAN DIEGO
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State | CA
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Zip | 92108-3729
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Country | US
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Telephone | 619-786-1356
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Fax |
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Provider Business Mailing Address
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Address Line | 6393 BADGER LAKE AVE
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City | SAN DIEGO
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State | CA
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Zip | 92119-3316
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Country | US
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Telephone | 619-272-1522
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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 | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 80886
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License Number State | CA
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