Provider Demographics
NPI:1508374281
Name:ANDORKA, DEBORAH AGNES (LMFT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:AGNES
Last Name:ANDORKA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:
Other - Last Name:ANDORKA-ACEVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3831 HUGHES AVE STE 509
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-6861
Mailing Address - Country:US
Mailing Address - Phone:925-282-1778
Mailing Address - Fax:415-296-5299
Practice Address - Street 1:3831 HUGHES AVE STE 509
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-6861
Practice Address - Country:US
Practice Address - Phone:925-282-1778
Practice Address - Fax:415-296-5299
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA145335106H00000X
CA220054610101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool