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Individual

MS. AMANDA ROSE VIERRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAADC, MAC, ICCDP

Contact information

Practice address
4637 COLUMBIA RIVER CT, SAN JOSE, CA 95136-2765
(408) 365-4559
Mailing address
4637 COLUMBIA RIVER CT, SAN JOSE, CA 95136-2765
(408) 365-4559

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LR01860216
CA
171M00000X
Case Manager/Care Coordinator
174H00000X
Health Educator

Other

Enumeration date
01/16/2007
Last updated
12/09/2021
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