Individual
MS. ANDREA L WERNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
191 WEST BURTON MESA BLVD, STE B, LOMPOC, CA 93436
(805) 733-4542
(805) 733-4392
Mailing address
1029 KERRY DR, SAN LUIS OBISPO, CA 93405
(805) 305-0942
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP13405
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0663623
TRIWEST
CA
05
—
GSP000390
—
CA
Enumeration date
11/21/2006
Last updated
07/08/2007
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