Provider Demographics
NPI:1518999580
Name:D'ANDREA, JAMES ANTHONY (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ANTHONY
Last Name:D'ANDREA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 KIRMAN AVE.
Mailing Address - Street 2:MAIL CODE 116
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-2597
Mailing Address - Country:US
Mailing Address - Phone:775-786-7200
Mailing Address - Fax:775-823-4093
Practice Address - Street 1:VA SIERRA NEVADA HEALTH CARE SYSTEM
Practice Address - Street 2:975 KIRMAN AVE.
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-2597
Practice Address - Country:US
Practice Address - Phone:775-786-7200
Practice Address - Fax:775-328-1858
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15439103TC0700X
NVPY0472103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PL154390Medicare ID - Type Unspecified
CAP51130Medicare UPIN