Andrea Marie McComas

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

172V00000X Issued in CA

Practice address

584 Kentucky Ave
Woodland, CA 95695-2779

Phone

(530) 661-3213

Fax

(530) 661-3027

NPI assigned

Jun 30, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Andrea Marie Conde Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1932361003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 RED PHEASANT DR",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956877750",
            "telephone_number": "707-365-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "584 KENTUCKY AVE",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956952779",
            "telephone_number": "530-661-3213",
            "fax_number": "530-661-3027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOMAS",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": "172V00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "CONDE",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mercy Apphia Mattsson-Boze, RN
• Laura Mazza, CRNP
• Blair Christine McAnelly
• Kehli Ayn McCaskill, P.A.
• Kathryn Louise McColgin
• Ryan D McConlogue, RN
• Phylicia McCord, PPS
• Everett McCoy
• Christopher Patrick McDermott, PA-C
• Kaitlin Nicole McEvilly

• Community Health Worker in Woodland, CA
• Providers in Woodland, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.