Healthcare Provider Details

I. General information

NPI: 1841110871
Provider Name (Legal Business Name): AMANDA MARIE HANSTAD AMFT, APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5475 E LA PALMA AVE STE 203
ANAHEIM CA
92807-2075
US

IV. Provider business mailing address

4770 EUREKA AVE
YORBA LINDA CA
92885-1400
US

V. Phone/Fax

Practice location:
  • Phone: 714-485-6778
  • Fax:
Mailing address:
  • Phone: 310-386-2129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number158400
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: