Provider Demographics
NPI:1609763176
Name:MARINO, ANDREA GARCIA (PPS)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:GARCIA
Last Name:MARINO
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 NOGALES ST
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-2945
Mailing Address - Country:US
Mailing Address - Phone:626-559-1329
Mailing Address - Fax:
Practice Address - Street 1:17840 VILLA CORTA ST
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91744-5342
Practice Address - Country:US
Practice Address - Phone:626-559-1329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA240012295101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool