Andrea Nicole Fennewald
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · View Park, CA
NPI 1922601558 · NPPES record last updated Nov 17, 2020
Key facts
- NPI
- 1922601558
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 5300 Angeles Vista Blvd
View Park, CA 90043-1648 - Phone
- (323) 627-0439
- NPI assigned
- Nov 17, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
5300 Angeles Vista Blvd
View Park, CA 90043-1648
Mailing address
5300 Angeles Vista Blvd
View Park, CA 90043-1648
Other providers in View Park, CA
- Empowered for Excellence Behavioral Health California LLC
- Empowered for Excellence Behavioral Health California LLC
- Yamely Espinosa Salas
- Jodivon Lee Fairclough
- Yordanos Feleke
- Lacey Finkelstein
- Christopher Gabriel Flores
- Lizvette Flores
- Tierra Fuller
- Alondra Garcia
All providers in View Park, CA · Student in an Organized Health Care Education/Training Program in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.