MEDICARE: ANDREA URRUTIA

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	363LF0000X	Family Nurse Practitioner	95038573	CA

General Provider Information

NPI Number	:	1922951581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA URRUTIA

Provider Business Mailing Address
First Line	:	9806 VIDOR DR APT 101
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-1083
Country	:	US
Telephone Number	:	210-857-8405
Fax Number	:

Provider Business Practice Location Address
First Line	:	1959 KINGSDALE AVE
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-3417
Country	:	US
Telephone Number	:	310-214-1000
Fax Number	:

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

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	04/07/2026

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Directions to “ ANDREA URRUTIA ” Practice Location

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