Provider Demographics
NPI:1184937955
Name:ANDAYA, TESS MINIANO (CCP)
Entity type:Individual
Prefix:MRS
First Name:TESS
Middle Name:MINIANO
Last Name:ANDAYA
Suffix:
Gender:F
Credentials:CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 WARFORD TER
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-2808
Mailing Address - Country:US
Mailing Address - Phone:925-253-9254
Mailing Address - Fax:650-571-9990
Practice Address - Street 1:8 WARFORD TER
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2808
Practice Address - Country:US
Practice Address - Phone:925-253-9254
Practice Address - Fax:650-571-9990
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA880003242T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist