Provider Demographics
NPI:1497973481
Name:ANDERMAN, DALIA (MFT)
Entity Type:Individual
Prefix:
First Name:DALIA
Middle Name:
Last Name:ANDERMAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:12577 BROOKTREE TRAIL
Mailing Address - City:OREGON HOUSE
Mailing Address - State:CA
Mailing Address - Zip Code:95962-0658
Mailing Address - Country:US
Mailing Address - Phone:530-692-0680
Mailing Address - Fax:530-692-0450
Practice Address - Street 1:1624 STARR DR
Practice Address - Street 2:SUITE 1
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95993-2636
Practice Address - Country:US
Practice Address - Phone:530-692-0680
Practice Address - Fax:530-692-0450
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39212106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist