Provider Demographics
NPI:1205979325
Name:ANDREWS, JIMMIE CHARLES (CDC)
Entity type:Individual
Prefix:MR
First Name:JIMMIE
Middle Name:CHARLES
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:CDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 E WORKMAN ST APT C
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-3645
Mailing Address - Country:US
Mailing Address - Phone:626-938-1957
Mailing Address - Fax:
Practice Address - Street 1:736 E WORKMAN ST APT C
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-3645
Practice Address - Country:US
Practice Address - Phone:626-938-1957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health