Provider Demographics
NPI:1912213331
Name:BYRNE, ANDREW LANCASTER (IMFT)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:LANCASTER
Last Name:BYRNE
Suffix:
Gender:M
Credentials:IMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 E LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-4511
Mailing Address - Country:US
Mailing Address - Phone:619-573-0682
Mailing Address - Fax:619-328-6591
Practice Address - Street 1:127 E LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020
Practice Address - Country:US
Practice Address - Phone:619-573-0682
Practice Address - Fax:619-328-6591
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-23
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63696106H00000X
CALMFT53477106H00000X
CAMFC53477106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist