Provider Demographics
NPI:1750493714
Name:ANDRADE, MARIA J (MFT)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:J
Last Name:ANDRADE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 W NAPA CT
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-1553
Mailing Address - Country:US
Mailing Address - Phone:909-624-2813
Mailing Address - Fax:909-624-2813
Practice Address - Street 1:680 W NAPA CT
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-1553
Practice Address - Country:US
Practice Address - Phone:909-624-2813
Practice Address - Fax:909-624-2813
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMN22283106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist