Basic Information
| Provider Information | |||||||||
| NPI: | 1336401777 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANDREANI | ||||||||
| FirstName: | MILENA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2035 E BALL RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928065157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145176300 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4000 W METROPOLITAN DR | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928683504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8668306011 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2012 | ||||||||
| LastUpdateDate: | 02/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 84392 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.