Individual
ANDREA U BAUCHOWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE, PATTON, CA 92369
(909) 425-7679
(909) 425-6635
Mailing address
3102 E. HIGHLAND AVENUE, MEDICAL STAFF OFFICE, PATTON, CA 92369
(909) 425-7679
(909) 425-6635
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810003302
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010064902
—
VA
Enumeration date
10/12/2006
Last updated
08/26/2013
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