Individual
AMANDA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
350 W BROOKSIDE AVE, CHERRY VALLEY, CA 92223-4073
(951) 845-1631
Mailing address
350 W BROOKSIDE AVE, CHERRY VALLEY, CA 92223-4073
(951) 845-1631
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4942
CA
Other
Enumeration date
08/03/2026
Last updated
08/03/2026
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