Provider Demographics
NPI:1942381736
Name:SIEGMAN, ANDREA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:SIEGMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12300 WILSHIRE BLVD.
Mailing Address - Street 2:SUITE 330
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025
Mailing Address - Country:US
Mailing Address - Phone:310-472-2039
Mailing Address - Fax:310-470-6575
Practice Address - Street 1:12300 WILSHIRE BLVD.
Practice Address - Street 2:SUITE 330
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025
Practice Address - Country:US
Practice Address - Phone:310-472-2039
Practice Address - Fax:310-470-6575
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT28845106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist