Provider Demographics
NPI:1700122736
Name:RAYOS, ANDREA INEZ (MAS)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:INEZ
Last Name:RAYOS
Suffix:
Gender:F
Credentials:MAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5265 TOSCANA WAY APT 224
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-5306
Mailing Address - Country:US
Mailing Address - Phone:909-274-8484
Mailing Address - Fax:
Practice Address - Street 1:5265 TOSCANA WAY APT 224
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-5306
Practice Address - Country:US
Practice Address - Phone:909-274-8484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-19
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health