Provider Demographics
NPI:1013705797
Name:MASTRIANNI-MOUNTS, ANDREA JEAN
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:JEAN
Last Name:MASTRIANNI-MOUNTS
Suffix:
Gender:
Credentials:
Other - Prefix:MS
Other - First Name:ANDREA
Other - Middle Name:J
Other - Last Name:MOUNTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:760 AVENIDA DEL VISTA
Mailing Address - Street 2:APT A
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882
Mailing Address - Country:US
Mailing Address - Phone:310-500-6247
Mailing Address - Fax:
Practice Address - Street 1:760 AVENIDA DEL VISTA
Practice Address - Street 2:APT A
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882
Practice Address - Country:US
Practice Address - Phone:310-500-6247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17541101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health