Individual
AMANDA BEAN HANNIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
2428 DWIGHT WAY STE NO7, BERKELEY, CA 94704-3506
(617) 513-8770
Mailing address
PO BOX 138, BERKELEY, CA 94701-0138
(617) 513-8770
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
CA
103TC0700X
Clinical Psychologist
Primary
32349
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
08/18/2014
Last updated
01/24/2021
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