Provider Demographics
NPI:1134329196
Name:SIEGEL, ANDREW JASON (MS)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:JASON
Last Name:SIEGEL
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7339 EL CAJON BLVD STE K
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-3435
Mailing Address - Country:US
Mailing Address - Phone:619-668-6200
Mailing Address - Fax:
Practice Address - Street 1:7339 EL CAJON BLVD STE K
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-3435
Practice Address - Country:US
Practice Address - Phone:619-668-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist