Individual
ANDREA MARTIN VAZ ANTUNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
3821 FRONT ST, SAN DIEGO, CA 92103-3019
(619) 867-2007
Mailing address
3821 FRONT ST, SAN DIEGO, CA 92103-3019
(619) 867-2007
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
94229
CA
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/25/2014
Last updated
01/13/2021
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