MEDICARE: MS. ANDREA A. SEITZ MFT

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	106H00000X	Marriage & Family Therapist	MFC45730	CA

General Provider Information

NPI Number	:	1295972271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANDREA A. SEITZ MFT

Provider Business Mailing Address
First Line	:	186 SEASCAPE RIDGE DR
Second Line	:
City	:	APTOS
State	:	CA
Zip	:	95003-5893
Country	:	US
Telephone Number	:	831-818-0780
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 HIGH ST
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95060-2545
Country	:	US
Telephone Number	:	831-818-0780
Fax Number	:

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

Provider Enumeration Date	:	01/13/2009
Last Update Date	:	01/13/2009

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