Individual
MRS. AMANDA MCKIBBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2361 E 29TH ST, OAKLAND, CA 94606-3511
(510) 488-0411
Mailing address
4091 LINCOLN AVE, OAKLAND, CA 94602-2429
(831) 239-3312
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
15157
CA
Other
Enumeration date
02/08/2018
Last updated
01/03/2022
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