Provider Demographics
NPI:1720244270
Name:ANDREW, JESSICA (BACHELORS)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:ANDREW
Suffix:
Gender:F
Credentials:BACHELORS
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:ANDREW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BACHELORS
Mailing Address - Street 1:730 MEDICAL CENTER CT
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911
Mailing Address - Country:US
Mailing Address - Phone:619-397-6977
Mailing Address - Fax:
Practice Address - Street 1:730 MEDICAL CENTER CT
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91901
Practice Address - Country:US
Practice Address - Phone:619-397-6977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health