Provider Demographics
NPI:1275969354
Name:AOUN, ANDREA RITA-MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:RITA-MARIE
Last Name:AOUN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 S GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-4141
Mailing Address - Country:US
Mailing Address - Phone:213-841-1020
Mailing Address - Fax:
Practice Address - Street 1:10421 S FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-4423
Practice Address - Country:US
Practice Address - Phone:323-418-4205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30371103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical