Provider Demographics
NPI:1619733706
Name:ORELLANA, ANDREA ARIELLE (BCAT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:ARIELLE
Last Name:ORELLANA
Suffix:
Gender:F
Credentials:BCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6160 CORNERSTONE CT E STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3724
Mailing Address - Country:US
Mailing Address - Phone:858-304-6440
Mailing Address - Fax:
Practice Address - Street 1:21515 HAWTHORNE BLVD STE GL-100
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6501
Practice Address - Country:US
Practice Address - Phone:424-571-2618
Practice Address - Fax:424-571-2339
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00018987106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician