Individual
AMANDA VISSERING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
U
Credential
LPCC, LMHC, PPSC
Contact information
Practice address
30 PROFESSIONAL CENTER PKWY, SAN RAFAEL, CA 94903-2757
(206) 572-0805
Mailing address
8945 GOLF LINKS RD, OAKLAND, CA 94605-4124
(510) 654-4004
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
8679
CA
101YM0800X
Mental Health Counselor
LH61129627
WA
101YP2500X
Professional Counselor
Primary
8679
CA
Other
Enumeration date
06/08/2016
Last updated
12/21/2024
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