Ionatuivaiti, Andrew Glenn

Ionatuivaiti, Andrew Glenn is an sole proprietor health care provider with primary practice located at 909 Pico Blvd , Santa Monica CA 90405-1326. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Ionatuivaiti, Andrew Glenn can be contacted via phone (310) 314-6200.

Contact Information

Primary practice address
909 Pico Blvd Santa Monica CA 90405-1326
Phone: (310) 314-6200
Fax: (310) 399-5080
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X R1335360119 California
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X California

Profile Details

NPI number 1285195545
LBN Legal business name Ionatuivaiti, Andrew Glenn
Credentials CADC-1
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 28th, 2019
Last updated Nov 20th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285195545 NPPES
California MEDICAID R1335360119

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