Provider Demographics
NPI:1053502062
Name:SIJBRANT, ANDREAS W (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:ANDREAS
Middle Name:W
Last Name:SIJBRANT
Suffix:
Gender:M
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-3916
Mailing Address - Country:US
Mailing Address - Phone:650-533-9015
Mailing Address - Fax:
Practice Address - Street 1:905 LAUREL ST
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-3916
Practice Address - Country:US
Practice Address - Phone:650-678-9226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9208171100000X
CAND38175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist