Provider Demographics
NPI:1386668531
Name:DAVIDSON, ANDREA (AUD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 WILSHIRE BLVD STE 1028
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3108
Mailing Address - Country:US
Mailing Address - Phone:310-659-3660
Mailing Address - Fax:310-659-6335
Practice Address - Street 1:8500 WILSHIRE BLVD STE 1028
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3108
Practice Address - Country:US
Practice Address - Phone:310-659-3660
Practice Address - Fax:310-659-6335
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1573231H00000X, 231HA2400X
CAHA3481231HA2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Not Answered231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16127Medicare UPIN
CAWAU1573BMedicare UPIN