Provider Demographics
NPI:1295833648
Name:ROSSI, ANDREA L (LMFT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:L
Last Name:ROSSI
Suffix:
Gender:F
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:PO BOX 75
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95063-0075
Mailing Address - Country:US
Mailing Address - Phone:831-234-2284
Mailing Address - Fax:
Practice Address - Street 1:951 BLANCO CIR
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4451
Practice Address - Country:US
Practice Address - Phone:831-755-4359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT32740106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist