Provider Demographics
NPI:1073709358
Name:GUIDO, ANDREA SUZANNE (MSW, LCSW)
Entity Type:Individual
Prefix:MISS
First Name:ANDREA
Middle Name:SUZANNE
Last Name:GUIDO
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 E CESAR E CHAVEZ AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-1209
Mailing Address - Country:US
Mailing Address - Phone:323-267-3417
Mailing Address - Fax:
Practice Address - Street 1:4701 E CESAR E CHAVEZ AVE FL 2
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-1209
Practice Address - Country:US
Practice Address - Phone:323-267-3417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker