Provider Demographics
NPI:1861022451
Name:KARRER, ANDREA SERENA
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:SERENA
Last Name:KARRER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27720 JEFFERSON AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-2630
Mailing Address - Country:US
Mailing Address - Phone:951-365-3309
Mailing Address - Fax:
Practice Address - Street 1:27720 JEFFERSON AVE STE 150
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-2630
Practice Address - Country:US
Practice Address - Phone:951-365-3309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician