Individual
AMANDA KATHLEEN PEARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 N BARRANCA ST # 130, WEST COVINA, CA 91791-1637
(626) 701-4669
Mailing address
3839 AMANDA ST APT 228, WEST COVINA, CA 91792-2797
(909) 552-3391
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
41419
CA
Other
Enumeration date
01/27/2020
Last updated
01/13/2025
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