Provider Demographics
NPI:1225383870
Name:SHEEDY, ANDREA JANE (MA)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:JANE
Last Name:SHEEDY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 E LELAND RD STE C
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-4954
Mailing Address - Country:US
Mailing Address - Phone:925-252-9663
Mailing Address - Fax:
Practice Address - Street 1:130 E LELAND RD STE C
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-4954
Practice Address - Country:US
Practice Address - Phone:925-252-9663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT 80846106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist