Individual
AMANDA INGOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16759 LOS REYES AVE, SAN LEANDRO, CA 94578-2425
(510) 481-5731
Mailing address
2275 ARLINGTON DR, SAN LEANDRO, CA 94578-1132
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/18/2010
Last updated
05/18/2010
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