Provider Demographics
NPI:1497468433
Name:SNELLEN, ANDREA MARIE (ELECTROLOGIST)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARIE
Last Name:SNELLEN
Suffix:
Gender:F
Credentials:ELECTROLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 DEL MONTE CTR # 206
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-6156
Mailing Address - Country:US
Mailing Address - Phone:707-382-6644
Mailing Address - Fax:
Practice Address - Street 1:444 PEARL ST STE B1
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3040
Practice Address - Country:US
Practice Address - Phone:707-382-6644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL9773174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist