Provider Demographics
NPI:1437391802
Name:ANDREWS, KATE ELLEN (LAC)
Entity Type:Individual
Prefix:MRS
First Name:KATE
Middle Name:ELLEN
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:109 AVENIDA SANTA MARGARITA APT J
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-4240
Mailing Address - Country:US
Mailing Address - Phone:949-374-7093
Mailing Address - Fax:
Practice Address - Street 1:149 AVENIDA GRANADA
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-4055
Practice Address - Country:US
Practice Address - Phone:949-374-7093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12364171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist