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NPI Code Detail

MEDICARE: DEREK ANDRUCKO

MEDICARE: DEREK ANDRUCKO
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
1101YM0800XMental Health Counselor145358CA

General Provider Information

NPI Number : 1558214205
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEREK ANDRUCKO
Provider Business Mailing Address
First Line : 507 CAULFIELD CT
Second Line :
City : CLAYTON
State : CA
Zip : 94517-1006
Country : US
Telephone Number : 925-222-0628
Fax Number :
Provider Business Practice Location Address
First Line : 1470 MARIA LN STE 240
Second Line :
City : WALNUT CREEK
State : CA
Zip : 94596-5399
Country : US
Telephone Number : 510-694-4359
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2026
Last Update Date : 02/20/2026

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