Individual
MS. AMANDA FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4129 STATE ST, SANTA BARBARA, CA 93110-1848
(805) 964-4795
Mailing address
964 WEBER CIR, APT 204, VENTURA, CA 93003-8240
(805) 208-6797
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/17/2012
Last updated
05/17/2012
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