Provider Demographics
NPI:1629762489
Name:NISHIMI, ANDREA (LMFT, LPCC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:NISHIMI
Suffix:
Gender:F
Credentials:LMFT, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1844 SAN MIGUEL DR STE 306A
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-8610
Mailing Address - Country:US
Mailing Address - Phone:925-289-8025
Mailing Address - Fax:
Practice Address - Street 1:1844 SAN MIGUEL DR STE 306A
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-8610
Practice Address - Country:US
Practice Address - Phone:925-289-8025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2024-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA138874106H00000X
CA14711101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health