Provider Demographics
NPI:1932694932
Name:RAPP, ANDREA (CNMT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:RAPP
Suffix:
Gender:F
Credentials:CNMT
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:120 W 3RD AVE APT 903
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-1589
Mailing Address - Country:US
Mailing Address - Phone:720-290-4344
Mailing Address - Fax:
Practice Address - Street 1:3801 MIRANDA AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1290
Practice Address - Country:US
Practice Address - Phone:720-290-4344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CARHN000043212471N0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471N0900XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistNuclear Medicine Technology