Basic Information
| Provider Information | |||||||||
| NPI: | 1518999580 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | D'ANDREA | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | ANTHONY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 975 KIRMAN AVE. | ||||||||
| Address2: | MAIL CODE 116 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895022597 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757867200 | ||||||||
| FaxNumber: | 7758234093 | ||||||||
| Practice Location | |||||||||
| Address1: | VA SIERRA NEVADA HEALTH CARE SYSTEM | ||||||||
| Address2: | 975 KIRMAN AVE. | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895022597 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757867200 | ||||||||
| FaxNumber: | 7753281858 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 08/26/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | PSY15439 | CA | N | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103TC0700X | PY0472 | NV | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.