Provider Demographics
NPI:1659776581
Name:ANDREW SCHLEGELMILCH PH D
Entity Type:Organization
Organization Name:ANDREW SCHLEGELMILCH PH D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHLEGELMILCH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:415-812-4615
Mailing Address - Street 1:PO BOX 590592
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94159-0592
Mailing Address - Country:US
Mailing Address - Phone:415-812-4615
Mailing Address - Fax:
Practice Address - Street 1:3450 GEARY BLVD
Practice Address - Street 2:SUITE 213
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3375
Practice Address - Country:US
Practice Address - Phone:415-812-4615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22003261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)