Provider Demographics
NPI:1053633826
Name:MENDELSOHN, ANDREA (MA, MFT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:MENDELSOHN
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22231 MULHOLLAND HWY STE 202
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-5152
Mailing Address - Country:US
Mailing Address - Phone:818-634-4967
Mailing Address - Fax:
Practice Address - Street 1:22231 MULHOLLAND HWY STE 202
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-5152
Practice Address - Country:US
Practice Address - Phone:818-634-4967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC33020101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health