Individual
ANDREA NICOLE FENNEWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5300 ANGELES VISTA BLVD, VIEW PARK, CA 90043-1648
(323) 627-0439
Mailing address
5300 ANGELES VISTA BLVD, VIEW PARK, CA 90043-1648
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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