Provider Demographics
NPI:1023639390
Name:GEIGER, ANDREA (LAC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:GEIGER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1688 WILLOW ST STE B
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-5109
Mailing Address - Country:US
Mailing Address - Phone:408-279-9001
Mailing Address - Fax:
Practice Address - Street 1:1688 WILLOW ST STE B
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-5109
Practice Address - Country:US
Practice Address - Phone:408-279-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC18855171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist