Basic Information
| Provider Information | |||||||||
| NPI: | 1750999041 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARAMBURU | ||||||||
| FirstName: | ANDREA | ||||||||
| MiddleName: | |||||||||
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| OtherOrganizationType: | |||||||||
| OtherLastName: | CERVANTES | ||||||||
| OtherFirstName: | ANDREA | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1346 BAXTER CT | ||||||||
| Address2: | |||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953488411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2092331642 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3360 N HIGHWAY 59 STE G-K | ||||||||
| Address2: | |||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953489404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2097252125 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2020 | ||||||||
| LastUpdateDate: | 01/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 101YP2500X | 119531 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.