Provider Demographics
NPI:1609669571
Name:MAUSHARDT, ANDREA TATYANA
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:TATYANA
Last Name:MAUSHARDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13253 BLODGETT AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-5203
Mailing Address - Country:US
Mailing Address - Phone:562-685-6306
Mailing Address - Fax:
Practice Address - Street 1:13135 BARTON RD STE ABC
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-2757
Practice Address - Country:US
Practice Address - Phone:562-944-2794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst