Provider Demographics
NPI:1629184197
Name:CARMAN, ANDREW ROBERT (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:ROBERT
Last Name:CARMAN
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 1:550 WATER ST
Mailing Address - Street 2:STE F2
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-4131
Mailing Address - Country:US
Mailing Address - Phone:831-429-7429
Mailing Address - Fax:831-458-2482
Practice Address - Street 1:550 WATER ST
Practice Address - Street 2:STE F2
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-4131
Practice Address - Country:US
Practice Address - Phone:831-429-7429
Practice Address - Fax:831-458-2482
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY7445103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAR27728Medicare UPIN
CA00PL74450Medicare ID - Type Unspecified