Provider Demographics
NPI:1376155655
Name:LANDE, ANDREW LAWRENCE (LMFT)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:LAWRENCE
Last Name:LANDE
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 1:5030 STROHM AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-4151
Mailing Address - Country:US
Mailing Address - Phone:818-290-8390
Mailing Address - Fax:
Practice Address - Street 1:5030 STROHM AVE
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-4151
Practice Address - Country:US
Practice Address - Phone:818-290-8390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106800106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist