Provider Demographics
NPI:1598992323
Name:VITZ, ANDREA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:MARIE
Last Name:VITZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 29TH ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3519
Mailing Address - Country:US
Mailing Address - Phone:510-444-2663
Mailing Address - Fax:510-444-0747
Practice Address - Street 1:401 29TH ST
Practice Address - Street 2:SUITE 205
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3519
Practice Address - Country:US
Practice Address - Phone:510-444-2663
Practice Address - Fax:510-444-0747
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-19
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29962111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor