Provider Demographics
NPI:1689182503
Name:COLEMAN, ANDREA (MEDICAL ASSISTANT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 WASHINGTON RD
Mailing Address - Street 2:APT 814
Mailing Address - City:CHOWCHILLA
Mailing Address - State:CA
Mailing Address - Zip Code:93610-1914
Mailing Address - Country:US
Mailing Address - Phone:559-706-6770
Mailing Address - Fax:
Practice Address - Street 1:255 WASHINGTON RD
Practice Address - Street 2:APT 814
Practice Address - City:CHOWCHILLA
Practice Address - State:CA
Practice Address - Zip Code:93610-1914
Practice Address - Country:US
Practice Address - Phone:559-706-6770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-12
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2470A2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2470A2800XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health InformationAssistant Record Technician