Provider Demographics
NPI:1508080789
Name:HARVEY, ANDREA CATHRINE (MA, MFTI)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:CATHRINE
Last Name:HARVEY
Suffix:
Gender:F
Credentials:MA, MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11934 ROYAL RD APT 15
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-1352
Mailing Address - Country:US
Mailing Address - Phone:619-994-3657
Mailing Address - Fax:
Practice Address - Street 1:3940 HOME AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-5952
Practice Address - Country:US
Practice Address - Phone:619-262-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37-07261QM2800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health