1255624631 NPI number — DR. ANDREA FINKELSTEIN SHERMAN OTD, OTR/L

Table of content: DR. ANDREA FINKELSTEIN SHERMAN OTD, OTR/L (NPI 1255624631)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255624631 NPI number — DR. ANDREA FINKELSTEIN SHERMAN OTD, OTR/L

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHERMAN
Provider First Name:
ANDREA
Provider Middle Name:
FINKELSTEIN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
OTD, OTR/L
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FINKELSTEIN
Provider Other First Name:
ANDREA
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1255624631
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/18/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1570 E 17TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA ANA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92705-8502
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6076 BRISTOL PKWY
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
CULVER CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90230-6600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-642-7700
Provider Business Practice Location Address Fax Number:
310-645-0394
Provider Enumeration Date:
05/18/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225XP0200X , with the licence number:  00013005 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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