Individual
ANDRE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RADT
Contact information
Practice address
6022 VARIEL AVE, WOODLAND HILLS, CA 91367-3719
(818) 996-1051
Mailing address
6022 VARIEL AVE, WOODLAND HILLS, CA 91367-3719
(818) 996-1051
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1415510121
CA
103TA0400X
Addiction (Substance Use Disorder) Psychologist
R1415510121
CA
Other
Enumeration date
05/07/2021
Last updated
08/11/2023
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