Individual
ANDRE D CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
503 OCEAN FRONT WALK, VENICE, CA 90291
(310) 392-3070
Mailing address
503 OCEAN FRONT WALK, VENICE, CA 90291-2403
(310) 392-3070
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
R1480760922
CA
171M00000X
Case Manager/Care Coordinator
Primary
R1480760922
CA
Other
Enumeration date
09/28/2022
Last updated
04/08/2023
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