Individual
ANDREA LYNN CORNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25 N 14TH ST, SAN JOSE, CA 95112-6204
(408) 569-2139
Mailing address
25 N 14TH ST, SAN JOSE, CA 95112-6204
(408) 569-2139
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
A044440617
CA
Other
Enumeration date
04/17/2018
Last updated
04/17/2018
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