Provider Demographics
NPI:1295290922
Name:ADDINGTON, ANDREW WAYNE
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:WAYNE
Last Name:ADDINGTON
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 1:2610 W SHAW LN STE 105
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-2775
Mailing Address - Country:US
Mailing Address - Phone:559-437-1144
Mailing Address - Fax:
Practice Address - Street 1:10535 ROAD 35
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93636-8487
Practice Address - Country:US
Practice Address - Phone:559-645-0903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health