Provider Demographics
NPI:1023304813
Name:BUCHANAN, ANDREW MICHAEL
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:MICHAEL
Last Name:BUCHANAN
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:ANDY
Other - Middle Name:MICHAEL
Other - Last Name:BUCHANAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:160 E VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-5857
Mailing Address - Country:US
Mailing Address - Phone:408-459-9569
Mailing Address - Fax:
Practice Address - Street 1:160 E VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-5857
Practice Address - Country:US
Practice Address - Phone:408-459-9569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health