Provider Demographics
NPI:1013186261
Name:ASEBEDO, ANDREA (MFT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:ASEBEDO
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 WEST ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1725
Mailing Address - Country:US
Mailing Address - Phone:530-524-4849
Mailing Address - Fax:
Practice Address - Street 1:1724 WEST ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1725
Practice Address - Country:US
Practice Address - Phone:530-524-4849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45413101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health