Provider Demographics
NPI:1184795742
Name:MAJOR, ANDREA CLARISSIA (BA)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:CLARISSIA
Last Name:MAJOR
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2746 S HARCOURT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-2829
Mailing Address - Country:US
Mailing Address - Phone:323-733-6364
Mailing Address - Fax:
Practice Address - Street 1:3701 STOCKER ST STE 104
Practice Address - Street 2:
Practice Address - City:VIEW PARK
Practice Address - State:CA
Practice Address - Zip Code:90008-5145
Practice Address - Country:US
Practice Address - Phone:213-381-2931
Practice Address - Fax:213-385-8446
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator