Provider Demographics
NPI:1437273885
Name:DEVOTO, ANDREA JEAN (RN)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:JEAN
Last Name:DEVOTO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 MERCURY RD
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-6318
Mailing Address - Country:US
Mailing Address - Phone:925-449-5259
Mailing Address - Fax:925-449-5259
Practice Address - Street 1:1111 E STANLEY BLVD
Practice Address - Street 2:BLDG D, SUITE 112
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-4115
Practice Address - Country:US
Practice Address - Phone:925-243-1385
Practice Address - Fax:925-243-0127
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA414116163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse