Provider Demographics
NPI:1013969484
Name:ANDREWS, MARTHA L (AUD)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:L
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11301 WILSHIRE BLVD
Mailing Address - Street 2:W126
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90073
Mailing Address - Country:US
Mailing Address - Phone:310-268-3701
Mailing Address - Fax:310-268-4791
Practice Address - Street 1:11301 WILSHIRE BLVD
Practice Address - Street 2:W126
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90073-1003
Practice Address - Country:US
Practice Address - Phone:310-268-3701
Practice Address - Fax:310-268-4791
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1323231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist