Provider Demographics
NPI:1609072875
Name:DICKMAN, ANDREW (MA)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:
Last Name:DICKMAN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BAWLEY ST
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-4747
Mailing Address - Country:US
Mailing Address - Phone:949-487-1951
Mailing Address - Fax:949-487-1953
Practice Address - Street 1:3144 EL CAMINO REAL
Practice Address - Street 2:SUITE 105
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2194
Practice Address - Country:US
Practice Address - Phone:760-729-7800
Practice Address - Fax:760-729-7879
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 316237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter