Provider Demographics
NPI:1508048448
Name:VAN VRANKEN, ANDREA CABRAL (BSW)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:CABRAL
Last Name:VAN VRANKEN
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 BROADWAY STE 207
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-2767
Mailing Address - Country:US
Mailing Address - Phone:619-425-5609
Mailing Address - Fax:619-425-8349
Practice Address - Street 1:1105 BROADWAY STE 207
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-2767
Practice Address - Country:US
Practice Address - Phone:619-425-5609
Practice Address - Fax:619-425-8349
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health