Provider Demographics
NPI:1376028308
Name:ARDROUMLI, ANDREW ASEAL
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:ASEAL
Last Name:ARDROUMLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 IOWA DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-2447
Mailing Address - Country:US
Mailing Address - Phone:661-476-1246
Mailing Address - Fax:
Practice Address - Street 1:2121 41ST AVE STE 211
Practice Address - Street 2:
Practice Address - City:CAPITOLA
Practice Address - State:CA
Practice Address - Zip Code:95010-2058
Practice Address - Country:US
Practice Address - Phone:831-688-4240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician