Provider Demographics
NPI:1235210428
Name:PICKERING, ANDREW (LMFT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:PICKERING
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2423 CAMINO DEL RIO SOUTH
Mailing Address - Street 2:#103
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108
Mailing Address - Country:US
Mailing Address - Phone:619-994-1307
Mailing Address - Fax:619-293-3746
Practice Address - Street 1:2423 CAMINO DEL RIO SOUTH
Practice Address - Street 2:#103
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108
Practice Address - Country:US
Practice Address - Phone:619-994-1307
Practice Address - Fax:619-293-3746
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 42790106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist