Provider Demographics
NPI:1053878249
Name:SESSION, ANDREA MONIQUE (CERT HAIR LOS SPECIA)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:MONIQUE
Last Name:SESSION
Suffix:
Gender:F
Credentials:CERT HAIR LOS SPECIA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 LAS PALMAS DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-2313
Mailing Address - Country:US
Mailing Address - Phone:310-766-3378
Mailing Address - Fax:
Practice Address - Street 1:763 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4610
Practice Address - Country:US
Practice Address - Phone:310-766-3378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAKK3434451744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management