Individual
AMANDA JEAN ANDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT, MA
Contact information
Practice address
17744 SKY PARK CIR, IRVINE, CA 92614-6421
(949) 344-6566
Mailing address
60 CLOVER, LAKE FOREST, CA 92630-8368
(949) 344-6566
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
102510
CA
101Y00000X
Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
08/13/2018
Last updated
10/04/2019
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