Provider Demographics
NPI:1609698331
Name:CASARES, ANDREW ROBERT
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:ROBERT
Last Name:CASARES
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 1:401 W LA VETA AVE APT 33
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-2662
Mailing Address - Country:US
Mailing Address - Phone:714-467-1656
Mailing Address - Fax:
Practice Address - Street 1:23046 AVENIDA DE LA CARLOTA STE 600
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1537
Practice Address - Country:US
Practice Address - Phone:714-805-9070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst