Provider Demographics
NPI:1023586450
Name:TRIPP, ANDREW SCOTT
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:SCOTT
Last Name:TRIPP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5110 SHENANDOAH ST
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-5967
Mailing Address - Country:US
Mailing Address - Phone:805-901-6154
Mailing Address - Fax:
Practice Address - Street 1:5110 SHENANDOAH ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-5967
Practice Address - Country:US
Practice Address - Phone:805-901-6154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-03
Last Update Date:2018-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health