Provider Demographics
NPI:1932768454
Name:FOSTER, ANDREA CAROL-BREDEMEIER (RN,MSN, CSN)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:CAROL-BREDEMEIER
Last Name:FOSTER
Suffix:
Gender:F
Credentials:RN,MSN, CSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SPICEWOOD
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-1419
Mailing Address - Country:US
Mailing Address - Phone:618-972-2309
Mailing Address - Fax:
Practice Address - Street 1:1629 S CENTER ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-4111
Practice Address - Country:US
Practice Address - Phone:714-433-3481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-08
Last Update Date:2019-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA820381163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse