Provider Demographics
NPI:1649632381
Name:ANDREWS, DEBORAH (RTT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:RTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 JARENA DR
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95357-1319
Mailing Address - Country:US
Mailing Address - Phone:209-622-0218
Mailing Address - Fax:
Practice Address - Street 1:3521 JARENA DR
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95357-1319
Practice Address - Country:US
Practice Address - Phone:209-622-0218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHT000822112471R0002X
NY6798052471R0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471R0002XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiation Therapy