Basic Information
| Provider Information | |||||||||
| NPI: | 1700916939 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GALVAO | ||||||||
| FirstName: | ANDREA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MFTI. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4400 ROSEMEAD BLVD | ||||||||
| Address2: | SUITE 12 | ||||||||
| City: | PICO RIVERA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906601759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5626921517 | ||||||||
| FaxNumber: | 5626991378 | ||||||||
| Practice Location | |||||||||
| Address1: | 9140 WHITTIER BLVD | ||||||||
| Address2: | |||||||||
| City: | PICO RIVERA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906602444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5628014626 | ||||||||
| FaxNumber: | 5628014630 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2007 | ||||||||
| LastUpdateDate: | 03/14/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 90644 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.