Provider Demographics
NPI:1194854984
Name:ANDRADE, LUCY MARIA (MS, CCC SLP)
Entity Type:Individual
Prefix:MS
First Name:LUCY
Middle Name:MARIA
Last Name:ANDRADE
Suffix:
Gender:F
Credentials:MS, CCC SLP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:375 LAGUNA HONDA BLVD
Mailing Address - Street 2:LAGUNA HONDA HOSPITAL, SPEECH THERAPY DEPT.
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-1411
Mailing Address - Country:US
Mailing Address - Phone:415-759-4522
Mailing Address - Fax:415-759-6317
Practice Address - Street 1:375 LAGUNA HONDA BLVD
Practice Address - Street 2:LAGUNA HONDA HOSPITAL, SPEECH PATHOLOGY DEPT.
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-1411
Practice Address - Country:US
Practice Address - Phone:415-759-4522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 9398235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASP 9398OtherCA SPEECH LANGUAGE BOARD