Healthcare Provider Details

I. General information

NPI: 1437086337
Provider Name (Legal Business Name): AMANDA RAE FELIX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10410 W AVENUE K
LANCASTER CA
93536-7430
US

IV. Provider business mailing address

10410 W AVENUE K
LANCASTER CA
93536-7430
US

V. Phone/Fax

Practice location:
  • Phone: 661-429-8457
  • Fax:
Mailing address:
  • Phone: 661-429-8457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number38485
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: