Provider Demographics
NPI:1801442504
Name:ANDREWS, VIVIAN B (LMFT)
Entity type:Individual
Prefix:
First Name:VIVIAN
Middle Name:B
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23726
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-0726
Mailing Address - Country:US
Mailing Address - Phone:530-559-1427
Mailing Address - Fax:
Practice Address - Street 1:11740 DUBLIN BLVD STE 202D
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2825
Practice Address - Country:US
Practice Address - Phone:530-559-1427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-18
Last Update Date:2019-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT112343106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist