Provider Demographics
NPI:1457315699
Name:SCHNEIDER, ANDREA LYNN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LYNN
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 E FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-2710
Mailing Address - Country:US
Mailing Address - Phone:626-335-9086
Mailing Address - Fax:
Practice Address - Street 1:1433 E ROUTE 66
Practice Address - Street 2:SUITE E
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-3747
Practice Address - Country:US
Practice Address - Phone:626-241-6812
Practice Address - Fax:626-914-2801
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA215921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA21592OtherPROFESSIONAL LICENSE