Individual
MS. AMANDA JEANNA FATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1328 2ND ST, SANTA MONICA, CA 90401-1122
(310) 394-6889
(310) 394-6883
Mailing address
100 BAYVIEW AVE, BERKLEY, MA 02779-2200
(508) 685-8268
(508) 880-6848
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/17/2009
Last updated
12/12/2017
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