Provider Demographics
NPI:1508374281
Name:ANDORKA, DEBORAH (MA, MS)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:ANDORKA
Suffix:
Gender:F
Credentials:MA, MS
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:
Other - Last Name:ANDORKA-ACEVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10851 WHITBURN ST
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-5422
Mailing Address - Country:US
Mailing Address - Phone:310-245-7667
Mailing Address - Fax:
Practice Address - Street 1:3600 WILSHIRE BLVD STE 1500
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-2619
Practice Address - Country:US
Practice Address - Phone:213-389-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT94290106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist