Provider Demographics
NPI:1629807540
Name:D'ANDREA, BRENDEN JOSEPH
Entity type:Individual
Prefix:
First Name:BRENDEN
Middle Name:JOSEPH
Last Name:D'ANDREA
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 1:7512 W SAND RIVER WAY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-1461
Mailing Address - Country:US
Mailing Address - Phone:520-336-7245
Mailing Address - Fax:
Practice Address - Street 1:2025 W ORANGE GROVE RD STE 2
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-1110
Practice Address - Country:US
Practice Address - Phone:520-584-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant