Provider Demographics
NPI:1043481096
Name:ANDRES, LEILA
Entity Type:Individual
Prefix:
First Name:LEILA
Middle Name:
Last Name:ANDRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 S FAIRVIEW ST UNIT H
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-5953
Mailing Address - Country:US
Mailing Address - Phone:949-338-2251
Mailing Address - Fax:
Practice Address - Street 1:2805 S FAIRVIEW ST UNIT H
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-5953
Practice Address - Country:US
Practice Address - Phone:949-338-2251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator