Healthcare Provider Details

I. General information

NPI: 1699685339
Provider Name (Legal Business Name): AMANDA DECKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

591 REDWOOD HWY FRONTAGE RD STE 2235
MILL VALLEY CA
94941-6028
US

IV. Provider business mailing address

591 REDWOOD HWY FRONTAGE RD STE 2235
MILL VALLEY CA
94941-6028
US

V. Phone/Fax

Practice location:
  • Phone: 415-381-8707
  • Fax: 415-634-3066
Mailing address:
  • Phone: 415-381-8707
  • Fax: 415-634-3066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: