Provider Demographics
NPI:1801245121
Name:SCZESNY, ANDREA (RN)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:SCZESNY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3839 LOS FELIZ BLVD
Mailing Address - Street 2:APT 205
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-2465
Mailing Address - Country:US
Mailing Address - Phone:419-575-6869
Mailing Address - Fax:
Practice Address - Street 1:1225 W 190TH ST
Practice Address - Street 2:SUITE 470
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90248-4320
Practice Address - Country:US
Practice Address - Phone:310-515-8113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA840760363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health