Individual
AMANDA BREEDLOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1666 PRECISION PARK LN, SAN DIEGO, CA 92173-1346
(619) 662-4100
(619) 600-4870
Mailing address
1601 PRECISION PARK LN, SAN DIEGO, CA 92173-1345
(619) 662-4100
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
139230
CA
106H00000X
Marriage & Family Therapist
259918
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100625550
—
KY
Enumeration date
02/28/2017
Last updated
08/28/2023
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