Individual
DR. AMANDA MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
CALIFORNIA MENS COLONY, HIGHWAY 1, SAN LUIS OBISPO, CA 93409-0001
(805) 547-7900
Mailing address
253 10TH AVE, UNIT 624, SAN DIEGO, CA 92101-7453
(619) 417-4779
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
31063
CA
103TF0200X
Forensic Psychologist
—
CA
Other
Enumeration date
12/30/2015
Last updated
12/15/2023
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