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NPI Code Detail

MEDICARE: ANDREA PATREECE COOK APRN, PMHNP-BC

MEDICARE: ANDREA PATREECE COOK APRN, PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner295300AZ
2363LP0808XPsychiatric/Mental Health Nurse Practitioner95027465CA

General Provider Information

NPI Number : 1225710833
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA PATREECE COOK APRN, PMHNP-BC
Provider Business Mailing Address
First Line : 5060 SHOREHAM PL STE 330
Second Line :
City : SAN DIEGO
State : CA
Zip : 92122-5976
Country : US
Telephone Number : 619-866-0998
Fax Number :
Provider Business Practice Location Address
First Line : 5060 SHOREHAM PL STE 330
Second Line :
City : SAN DIEGO
State : CA
Zip : 92122-5976
Country : US
Telephone Number : 619-866-0998
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2023
Last Update Date : 04/17/2026

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