Individual
ANDRE SERITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3270 KERNER BLVD, SAN RAFAEL, CA 94901-4840
(415) 473-6828
Mailing address
1445 FRUITDALE AVE UNIT 107, SAN JOSE, CA 95128-3271
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/17/2021
Last updated
09/23/2021
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