Provider Demographics
NPI:1467610451
Name:ANDRES-ELIAS, PAMELA LAUREN (MS)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:LAUREN
Last Name:ANDRES-ELIAS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:L
Other - Last Name:ANDRES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:120 VALLEY OAKS DR
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:CA
Mailing Address - Zip Code:94507-2008
Mailing Address - Country:US
Mailing Address - Phone:415-867-1123
Mailing Address - Fax:
Practice Address - Street 1:1425 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5318
Practice Address - Country:US
Practice Address - Phone:925-295-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17612235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist