Individual
ANDREW ALAN DALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
135 CIELO LN APT 303, NOVATO, CA 94949-3310
(805) 868-9086
Mailing address
135 CIELO LN APT 303, NOVATO, CA 94949-3310
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14049-RAC
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D6710328
—
CA
Enumeration date
07/03/2020
Last updated
07/03/2020
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