Provider Demographics
NPI:1942323530
Name:SCHWARTZ, ANDREW N (PHD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:N
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23120 ALICIA PKWY
Mailing Address - Street 2:SUITE 241
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-1210
Mailing Address - Country:US
Mailing Address - Phone:949-588-5984
Mailing Address - Fax:949-588-6355
Practice Address - Street 1:23120 ALICIA PKWY
Practice Address - Street 2:SUITE 241
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-1210
Practice Address - Country:US
Practice Address - Phone:949-588-5984
Practice Address - Fax:949-588-6355
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY4989103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY4987OtherSTATE LICENSE
CACP4989Medicare PIN