Provider Demographics
NPI:1518013721
Name:WHALING, ANDREW (MFT)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:
Last Name:WHALING
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N MARENGO AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1504
Mailing Address - Country:US
Mailing Address - Phone:626-564-0480
Mailing Address - Fax:626-356-7414
Practice Address - Street 1:215 N MARENGO AVE FL 3
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1504
Practice Address - Country:US
Practice Address - Phone:626-564-0480
Practice Address - Fax:626-356-7414
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC29756106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist