Individual
ANDREW DONALD DERTIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 MARKET ST FL 1, SAN FRANCISCO, CA 94103-1589
(415) 863-3883
Mailing address
1563 MISSION ST, SAN FRANCISCO, CA 94103-2543
(415) 762-3700
(415) 865-0119
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1410691120
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
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Other
Enumeration date
12/03/2020
Last updated
03/17/2023
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