Provider Demographics
NPI:1376050823
Name:GIOVANELLI, ANDREA ROSEMARY (PA)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:ROSEMARY
Last Name:GIOVANELLI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:937 SHOREPOINT CT APT G114
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-5819
Mailing Address - Country:US
Mailing Address - Phone:707-315-1429
Mailing Address - Fax:
Practice Address - Street 1:365 HAWTHORNE AVE STE 201
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3114
Practice Address - Country:US
Practice Address - Phone:510-452-1345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant