Provider Demographics
NPI:1154505550
Name:MCDONALD, ANDREA L (CAADE)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:L
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:CAADE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 HAZEN DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-2009
Mailing Address - Country:US
Mailing Address - Phone:760-518-1972
Mailing Address - Fax:
Practice Address - Street 1:243 S ESCONDIDO BLVD # 120
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4116
Practice Address - Country:US
Practice Address - Phone:760-741-0122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)