Provider Demographics
NPI:1780802462
Name:CONDEY, ANDREW (PHD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:CONDEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1496 SOLANO AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-2148
Mailing Address - Country:US
Mailing Address - Phone:510-525-5660
Mailing Address - Fax:510-524-3770
Practice Address - Street 1:1496 SOLANO AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-2148
Practice Address - Country:US
Practice Address - Phone:510-525-5660
Practice Address - Fax:510-524-3770
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY5784103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical