Provider Demographics
NPI:1770952970
Name:ANDREWS, JUANITA RENEE (BSN, RN)
Entity type:Individual
Prefix:
First Name:JUANITA
Middle Name:RENEE
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:MRS
Other - First Name:JUANITA
Other - Middle Name:RENEE
Other - Last Name:ANDREWS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:1738 S TREMONT ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-5309
Mailing Address - Country:US
Mailing Address - Phone:760-439-2800
Mailing Address - Fax:
Practice Address - Street 1:1738 S TREMONT ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-5309
Practice Address - Country:US
Practice Address - Phone:760-439-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95055195163WP0808X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult