Healthcare Provider Details

I. General information

NPI: 1144146572
Provider Name (Legal Business Name): AMANDA ALICEN REECE M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6321 HWY 116
FORESTVILLE CA
95436-9606
US

IV. Provider business mailing address

16721 BURL LN
OCCIDENTAL CA
95465-9402
US

V. Phone/Fax

Practice location:
  • Phone: 707-887-2279
  • Fax:
Mailing address:
  • Phone: 209-981-6628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number19477
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: