Provider Demographics
NPI:1376155655
Name:LANDE, ANDREW LAWRENCE (LMFT)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:LAWRENCE
Last Name:LANDE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11729 OTSEGO ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3220
Mailing Address - Country:US
Mailing Address - Phone:818-290-8390
Mailing Address - Fax:
Practice Address - Street 1:11729 OTSEGO ST
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-3220
Practice Address - Country:US
Practice Address - Phone:818-290-8390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-19
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106800106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist