MEDICARE: CAROLINE ANN D'ANDREA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT 13704	CA

General Provider Information

NPI Number	:	1093006033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE ANN D'ANDREA

Provider Business Mailing Address
First Line	:	2238 S CARMELINA AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1077
Country	:	US
Telephone Number	:	203-470-3365
Fax Number	:

Provider Business Practice Location Address
First Line	:	2238 S CARMELINA AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1077
Country	:	US
Telephone Number	:	203-470-3365
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2011
Last Update Date	:	04/23/2014

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Directions to “ CAROLINE ANN D'ANDREA ” Practice Location

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