Provider Demographics
NPI:1881862035
Name:REASBECK, ANDREW (MFT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:REASBECK
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2667 CAMINO DEL RIO S
Mailing Address - Street 2:SUITE301
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3707
Mailing Address - Country:US
Mailing Address - Phone:619-294-3310
Mailing Address - Fax:
Practice Address - Street 1:2667 CAMINO DEL RIO S
Practice Address - Street 2:SUITE301
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3707
Practice Address - Country:US
Practice Address - Phone:619-294-3310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22430106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist