Provider Demographics
NPI:1730688755
Name:ANDRES, KRISTIN (MD)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:ANDRES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 WELCH RD STE 305
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1510
Mailing Address - Country:US
Mailing Address - Phone:650-721-6849
Mailing Address - Fax:650-725-8343
Practice Address - Street 1:750 WELCH RD STE 305
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1510
Practice Address - Country:US
Practice Address - Phone:650-721-6849
Practice Address - Fax:650-725-8343
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA1779452080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program